Individual
JACQUELINE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 NW 25TH ST, OKLAHOMA CITY, OK 73106-5629
(405) 525-2525
Mailing address
5301 N MERIDIAN AVE APT 335, OKLAHOMA CITY, OK 73112-2190
(405) 905-2645
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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