Individual
MS. ASHLEY M LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4028 W 104TH PL S, JENKS, OK 74037-1912
(732) 771-4049
Mailing address
4028 W 104TH PL S, JENKS, OK 74037-1912
(732) 771-4049
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5296
OK
390200000X
Student in an Organized Health Care Education/Training Program
P082573608
OK
Other
Enumeration date
04/20/2012
Last updated
09/18/2019
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