Provider Demographics
NPI:1033524210
Name:HEWITT, GENEVA E
Entity Type:Individual
Prefix:
First Name:GENEVA
Middle Name:E
Last Name:HEWITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GENEVA
Other - Middle Name:
Other - Last Name:EBOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34831
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-4831
Mailing Address - Country:US
Mailing Address - Phone:707-761-6268
Mailing Address - Fax:702-359-0674
Practice Address - Street 1:825 COPPER MOON LN
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-1908
Practice Address - Country:US
Practice Address - Phone:707-761-6268
Practice Address - Fax:702-359-0674
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool