Individual
ANNALIZA GONZALES LEWERK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44 MARITIME DR, MYSTIC, CT 06355-1958
(860) 572-4241
Mailing address
44 MARITIME DR, MYSTIC, CT 06355-1958
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0001108
CT
224Z00000X
Occupational Therapy Assistant
O001108
CT
224ZE0001X
Environmental Modification Occupational Therapy Assistant
O001108
CT
Other
Enumeration date
05/13/2019
Last updated
05/13/2019
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