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 |