Individual
KHADIJAH JEAN-MARIE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6324 FAIRVIEW RD STE 460, CHARLOTTE, NC 28210-3374
(980) 302-8611
(980) 302-8624
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 366-1264
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
00268
NC
Other
Enumeration date
05/19/2020
Last updated
09/10/2025
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