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Individual
MRS. KELLEY D LEWIS
Active
Individual
MRS. KELLEY D LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
PTA 942
AR
225X00000X
Occupational Therapist
Primary
OTR1999
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143895721
—
AR
Enumeration date
05/06/2006
Last updated
07/21/2023
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