Provider Demographics
NPI:1871297812
Name:SEWARDS, ALLENE
Entity type:Individual
Prefix:
First Name:ALLENE
Middle Name:
Last Name:SEWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 ELM ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3672
Mailing Address - Country:US
Mailing Address - Phone:505-242-1010
Mailing Address - Fax:505-242-1551
Practice Address - Street 1:239 ELM ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3672
Practice Address - Country:US
Practice Address - Phone:505-242-1010
Practice Address - Fax:505-242-1551
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator