Individual
KAITLIN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5220 6TH STREET FRONTAGE RD E STE 1700, SPRINGFIELD, IL 62703-5771
(217) 525-8332
Mailing address
5220 6TH STREET FRONTAGE RD E STE 1700, SPRINGFIELD, IL 62703-5771
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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