Individual
RAFAEL LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
2901 66TH AVE N, BROOKLYN CENTER, MN 55430-1718
(612) 203-6414
Mailing address
2901 66TH AVE N, BROOKLYN CENTER, MN 55430-1718
(612) 203-6414
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306118
MN
Other
Enumeration date
02/14/2025
Last updated
02/20/2025
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