Healthcare Provider Details

I. General information

NPI: 1013551118
Provider Name (Legal Business Name): JULIET C EWING MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 G ST NW SUITE 800
WASHINGTON DC
20005-6705
US

IV. Provider business mailing address

4405 18TH ST NW
WASHINGTON DC
20011-4229
US

V. Phone/Fax

Practice location:
  • Phone: 703-552-2722
  • Fax:
Mailing address:
  • Phone: 202-680-4768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGPC00583
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: