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Individual

LISA LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
118 PEARL AVE N, DOUGLAS, GA 31533
(912) 331-0846
(678) 792-4894
Mailing address
2051 BELL TELEPHONE RD, HAZLEHURST, GA 31539-4643
(912) 347-4732

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP010109
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SLP010109
SPEECH LANGUAGE PATHOLOGIST
GA
Enumeration date
07/31/2017
Last updated
06/17/2018
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