| NPI | 1013288224 | 
|---|---|
| Former Name | MAXWELL JAMES EWING | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OR 1013288224) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2012-01-19 | 
| Last Update Date | 2022-07-21 |