Individual
DEIDRA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 470-6900
Mailing address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 470-6900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW13411
FL
Other
Enumeration date
08/23/2020
Last updated
06/21/2023
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