Provider Demographics
NPI:1871624577
Name:HOWARD, ALLISON LINLEY (DOM)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LINLEY
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W LUPITA RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4720
Mailing Address - Country:US
Mailing Address - Phone:575-520-2500
Mailing Address - Fax:
Practice Address - Street 1:1602 4TH ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3426
Practice Address - Country:US
Practice Address - Phone:575-520-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7336171100000X
NMDOM1248171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist