Ewing, Colleen Diane

Ewing, Colleen Diane is an individual health care provider with primary practice located at 40 Douglas Ave Nw , Roanoke VA 24012-4611. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Ewing, Colleen Diane can be contacted via phone (540) 852-2502.

Contact Information

Primary practice address
40 Douglas Ave Nw Roanoke VA 24012-4611
Phone: (540) 852-2502
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 0813000761 Virginia

Profile Details

NPI number 1700387404
LBN Legal business name Ewing, Colleen Diane
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2018
Last updated Feb 27th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700387404 NPPES
Virginia MEDICAID 0813000761

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