Individual
VANESSA KAY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
6235 W FILLY ST, BOISE, ID 83703-5049
(208) 955-8215
Mailing address
6235 W FILLY ST, BOISE, ID 83703-5049
(208) 955-8215
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/21/2019
Last updated
09/21/2019
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