Individual
ISIS EBONI ELISE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
110 S 12TH ST, WACO, TX 76701-1810
(254) 752-3451
Mailing address
PO BOX 890, WACO, TX 76703-0890
(254) 752-7899
(254) 756-3133
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
67802
TX
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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