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General NPI Number Information
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NPI Number | 1720576424
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Entity Type | Individual
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Provider Name | ALLISON ANN SEWOLICH PEER SPECIALIST
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Gender | Female
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Dates
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Enumeration Date | 04/27/2018
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 142 E STATE ST
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City | ATHENS
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State | OH
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Zip | 45701-1746
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Country | US
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Telephone | 740-593-3402
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W STATE ST APT J3
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City | ATHENS
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State | OH
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Zip | 45701-1555
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Country | US
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Telephone | 614-849-2754
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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