Individual
MISS KOURTNEY MARIE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 N HANCOCK ST, PHILADELPHIA, PA 19123-2334
(215) 834-0131
Mailing address
2812 W GIRARD AVE, PHILADELPHIA, PA 19130-1215
(814) 505-4428
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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