Doctor Name: | DR. FAWN D. HEWITT |
NPI Number: | 1356551907 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 3269 |
Business Practice Address: | 1918 Nw Corvette St. Waldport, OR - 97394 |
Business Phone Number: | 5415636649 |
Business Fax Number: | |
Mailing Address: | 1918 Nw Corvette St., P.o. Box 303 WALDPORT |
State: | OR |
Postal Code: | 973940303 |
Phone Number: | 5415636649 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 3269 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |