Individual
MISS KEISHA MICHELLE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CDE
Contact information
Practice address
3328 FORDINGTON PL, WALDORF, MD 20603-4446
(803) 840-3312
Mailing address
3328 FORDINGTON PL, WALDORF, MD 20603-4446
(803) 840-3312
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003478
VA
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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