Individual
MICAH Y LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, CLT
Contact information
Practice address
4586 CREST RIDGE LOOP, BLAIR, NE 68008-6406
(402) 800-7002
Mailing address
4586 CREST RIDGE LOOP, BLAIR, NE 68008-6406
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1689
NE
225X00000X
Occupational Therapist
2298
IA
Other
Enumeration date
01/22/2018
Last updated
07/10/2024
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