Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | MH0000454 | FL |
N | 103TC1900X | Counseling Psychologist | MH0000454 | FL |
NPI | 1114973823 |
---|---|
Provider Name | Dr. Aubrey K. Ewing |
First Address | Boynton Beach, FL 33435-6000 |
Second Address | Boynton Beach, FL 33435-6000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 08/09/2010 |