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General NPI Number Information
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NPI Number | 1518187194
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Entity Type | Individual
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Provider Name | MELISSA LEIGH EWING LCMFT
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 916 WILLIAMS
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City | GREAT BEND
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State | KS
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Zip | 67530-5027
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Country | US
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Telephone | 620-786-0687
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Fax | 620-793-7370
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Provider Business Mailing Address
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Address Line | 2203 WASHINGTON ST
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City | GREAT BEND
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State | KS
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Zip | 67530
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Country | US
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Telephone | 620-786-0687
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Fax | 620-793-7370
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT 723
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License Number State | KS
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