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General NPI Number Information
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NPI Number | 1629144605
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Entity Type | Individual
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Provider Name | JEANNE A EWING LCSW, BCD, BAS
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 2045 SPACE PARK DR SUITE 250
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City | NASSAU BAY
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State | TX
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Zip | 77058-6304
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Country | US
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Telephone | 713-503-8061
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Fax | 281-218-9277
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Provider Business Mailing Address
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Address Line | 2045 SPACE PARK DR SUITE 250
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City | NASSAU BAY
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State | TX
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Zip | 77058-6304
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Country | US
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Telephone | 713-503-8061
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Fax | 281-218-9277
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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