Provider Demographics
NPI:1043529241
Name:ALLMAN, MIZUNA (MS)
Entity type:Individual
Prefix:MRS
First Name:MIZUNA
Middle Name:
Last Name:ALLMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:MIZUNA
Other - Middle Name:
Other - Last Name:SHIMOHARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:931 CHEVY WAY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4127
Mailing Address - Country:US
Mailing Address - Phone:541-535-6239
Mailing Address - Fax:541-512-1026
Practice Address - Street 1:450 S 4TH ST
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2224
Practice Address - Country:US
Practice Address - Phone:541-535-6239
Practice Address - Fax:541-512-1026
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health