Individual
MR. VONNIE LEE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC MENTAL HEALTH
Contact information
Practice address
111 N 20TH ST, PHILOMATH, OR 97370-9535
(541) 368-4313
(541) 929-4967
Mailing address
PO BOX 455, PHILOMATH, OR 97370-0455
(541) 368-4313
(541) 929-4967
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C0069
OR
101Y00000X
Counselor
LPC C0069
OR
Other
Enumeration date
07/08/2010
Last updated
07/08/2010
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