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Individual

LAWRENCE LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
829 STATE HWY, BETHEL, AK 99559
(907) 543-6100
Mailing address
PO BOX 528, BETHEL, AK 99559-0528

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MH0150
AK
Enumeration date
02/12/2008
Last updated
08/08/2012
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