Individual
MAKENZIE WISE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA
Contact information
Practice address
920 CAMBRIDGE ST, FAYETTEVILLE, NC 28303-5300
(910) 493-3555
(910) 493-3520
Mailing address
920 CAMBRIDGE ST, FAYETTEVILLE, NC 28303-5300
(910) 493-3555
(910) 493-3520
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
0-23-14333
NC
Other
Enumeration date
11/02/2020
Last updated
01/23/2024
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