Provider Demographics
NPI:1720466881
Name:EWART, JOANNE
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:EWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14021 LAKE CANDLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-3009
Mailing Address - Country:US
Mailing Address - Phone:305-793-2274
Mailing Address - Fax:
Practice Address - Street 1:14021 LAKE CANDLEWOOD CT
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-3009
Practice Address - Country:US
Practice Address - Phone:305-793-2274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-09
Last Update Date:2015-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist