Undre Cordell Allen, MA, RBT
Individual provider Active NPI Behavior Technician · Brookhaven, GA
NPI 1013523182 · NPPES record last updated Sep 23, 2020
Key facts
- NPI
- 1013523182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-20-135486 (GA)
- Practice address
- 3105 Clairmont Rd NE
Brookhaven, GA 30329-1015 - Phone
- (470) 241-1353
- Fax
- (317) 520-8200
- NPI assigned
- Sep 23, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-135486 | GA | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-135486 | GA | Yes |
Addresses
Primary practice location
3105 Clairmont Rd NE
Brookhaven, GA 30329-1015
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
Other providers in Brookhaven, GA
- Rose Alcime
- Jamilet Cristy Alegria
- William Alexander
- Yamini Alla
- John Leatherbury Allen
- Alpha Athletic Development LLC
- Anastasia Brown Alvarado
- Amalia Consulting, LLC
- Amber Spezzano LCSW LLC
- Mary Leigh Amerein
All providers in Brookhaven, GA · Behavior Technician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.