Provider Demographics
NPI:1720576424
Name:SEWOLICH, ALLISON ANN (PEER SPECIALIST)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ANN
Last Name:SEWOLICH
Suffix:
Gender:F
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W STATE ST APT J3
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1555
Mailing Address - Country:US
Mailing Address - Phone:614-849-2754
Mailing Address - Fax:
Practice Address - Street 1:142 E STATE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1746
Practice Address - Country:US
Practice Address - Phone:740-593-3402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health