Provider Demographics
NPI:1356470298
Name:HEWITT, CAROL LOUISE (EDD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LOUISE
Last Name:HEWITT
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HICKORY HL
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-9728
Mailing Address - Country:US
Mailing Address - Phone:814-696-7482
Mailing Address - Fax:
Practice Address - Street 1:514 E PLEASANT VALLEY BLVD STE 4
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-5574
Practice Address - Country:US
Practice Address - Phone:814-944-9970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008812L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist