Healthcare Provider Details

I. General information

NPI: 1447188545
Provider Name (Legal Business Name): AHYANA MONNA SEWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SAINT PAUL ST
BALTIMORE MD
21202-3056
US

IV. Provider business mailing address

1501 SAINT PAUL ST
BALTIMORE MD
21202-3056
US

V. Phone/Fax

Practice location:
  • Phone: 443-977-8439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: