Individual
KYLIE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
349 BOGLE ST, SOMERSET, KY 42503-2895
(606) 485-4611
Mailing address
PO BOX 254, LONDON, KY 40743-0254
(606) 280-0461
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
261621
KY
171M00000X
Case Manager/Care Coordinator
—
KY
Other
Enumeration date
02/26/2018
Last updated
12/31/2019
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