Provider Demographics
NPI:1407679301
Name:ALLEN, DELORES DRUCILLA
Entity type:Individual
Prefix:
First Name:DELORES
Middle Name:DRUCILLA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 SHADY AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2422
Mailing Address - Country:US
Mailing Address - Phone:484-554-3430
Mailing Address - Fax:
Practice Address - Street 1:1600 CORNELL ST
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-4613
Practice Address - Country:US
Practice Address - Phone:412-664-3770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker