Provider Demographics
NPI:1447332028
Name:ALLISON, STEPHEN H (PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:H
Last Name:ALLISON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BAY WATER DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-4203
Mailing Address - Country:US
Mailing Address - Phone:325-674-6838
Mailing Address - Fax:325-674-6764
Practice Address - Street 1:1111 INDUSTRIAL BLVD BLDG 2
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7929
Practice Address - Country:US
Practice Address - Phone:325-674-6838
Practice Address - Fax:325-674-6764
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23019103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical