Individual
BROOKELYN MIKIELA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7210 BEACON WOODS DR, HUDSON, FL 34667-1974
(727) 863-1521
Mailing address
111 VALDEZ CIR, GEORGETOWN, KY 40324-8000
(859) 699-3397
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
19205
FL
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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