Healthcare Provider Details

I. General information

NPI: 1205180031
Provider Name (Legal Business Name): AUBREY K. EWING, PH.D. & ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2012
Last Update Date: 10/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 S FEDERAL HWY
BOYNTON BEACH FL
33435-6000
US

IV. Provider business mailing address

1230 S FEDERAL HWY
BOYNTON BEACH FL
33435-6000
US

V. Phone/Fax

Practice location:
  • Phone: 561-742-7122
  • Fax:
Mailing address:
  • Phone: 561-742-7122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH0000454
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. AUBREY K. EWING
Title or Position: PRESIDENT/CLINICAL DIRECTOR
Credential: PH.D.
Phone: 561-742-7122