Individual
DONNA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
169 MITTIE HADDOCK DR, CAMERON, NC 28326-9379
(800) 991-6070
Mailing address
169 MITTIE HADDOCK DR, CAMERON, NC 28326-9379
(800) 991-6070
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
NC
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BT106S00000X
—
NC
Enumeration date
05/30/2017
Last updated
05/30/2017
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