IndividualActive
Allison Deatherage, PHD
NPI 1659585099 · Clinical Psychologist · Charleston Afb, SC
Provider details
- NPI number
- 1659585099
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 7351 (OH)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
204 W Hill Blvd
Charleston Afb, SC 29404-4704
Phone: (843) 963-6852
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 21467
Columbus, OH 43221-0467
Registry dates
- Enumerated
- 2007-05-09
- Last updated
- 2020-11-20
- Certified
- 2020-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.