Healthcare Provider Details

I. General information

NPI: 1538079314
Provider Name (Legal Business Name): ALONNI RAE HARRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S DIAMOND AVE
DEMING NM
88030-4710
US

IV. Provider business mailing address

1001 S DIAMOND AVE
DEMING NM
88030-4710
US

V. Phone/Fax

Practice location:
  • Phone: 575-494-5770
  • Fax:
Mailing address:
  • Phone: 575-494-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2026-0977
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number364047
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: