| NPI | 1619060571 |
|---|---|
| Former Name | CYNTHIA JEANETTE EWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301012169) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MI 6301012169) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |