Individual
SHANIECE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 323-0174
(706) 256-3264
Mailing address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 327-0279
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/30/2011
Last updated
08/20/2013
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