Provider Demographics
NPI:1396484838
Name:EWING, ELIZABETH (BHT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:EWING
Suffix:
Gender:F
Credentials:BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 E SOUTHERN AVE STE E1
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7744
Mailing Address - Country:US
Mailing Address - Phone:480-542-4668
Mailing Address - Fax:
Practice Address - Street 1:2600 E SOUTHERN AVE STE E1
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7744
Practice Address - Country:US
Practice Address - Phone:480-542-4668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)