Provider Demographics
NPI:1891420360
Name:ALLMAN, JACQUELINE K (MS)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:K
Last Name:ALLMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:PATRICIA
Other - Last Name:KELK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 BAPTIST HILL RD
Mailing Address - Street 2:
Mailing Address - City:CANTERBURY
Mailing Address - State:NH
Mailing Address - Zip Code:03224-2509
Mailing Address - Country:US
Mailing Address - Phone:603-491-4306
Mailing Address - Fax:803-836-5004
Practice Address - Street 1:754 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-3012
Practice Address - Country:US
Practice Address - Phone:603-836-5003
Practice Address - Fax:603-836-5004
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH713106H00000X
VT097.0135345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional