Provider Demographics
NPI:1487418257
Name:ALLEN, ENA ROCHELLE
Entity type:Individual
Prefix:
First Name:ENA
Middle Name:ROCHELLE
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 1:4800 BERWYN HOUSE RD APT 504
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2454
Mailing Address - Country:US
Mailing Address - Phone:240-879-7389
Mailing Address - Fax:
Practice Address - Street 1:4800 BERWYN HOUSE RD APT 504
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-2454
Practice Address - Country:US
Practice Address - Phone:240-879-7389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant