Individual
MR. DONNIE BQ LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10948 N MAY AVE STE B, OKLAHOMA CITY, OK 73120-6224
(405) 751-8889
Mailing address
8821 WINDY HOLLOW DR, MIDWEST CITY, OK 73110-7460
(405) 361-4730
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200287120A
—
OK
Enumeration date
07/10/2012
Last updated
12/22/2012
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