Provider Demographics
NPI:1427384387
Name:EWING, KARI (BS, BCABA)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:EWING
Suffix:
Gender:F
Credentials:BS, BCABA
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:
Other - Last Name:SWINDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, BCABA
Mailing Address - Street 1:4015 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-7336
Mailing Address - Country:US
Mailing Address - Phone:706-326-2176
Mailing Address - Fax:
Practice Address - Street 1:4015 CRESTVIEW DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-7336
Practice Address - Country:US
Practice Address - Phone:706-326-2176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
0-14-3541OtherBACB CERTIFICANT NUMBER