Individual
MICHELLE ANN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 WALPOLE ST STE 207, STAFFORD, VA 22554-6546
(540) 383-7133
Mailing address
35 WALPOLE ST, STAFFORD, VA 22554-6546
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133002111
VA
103K00000X
Behavior Analyst
L-568
LA
103K00000X
Behavior Analyst
—
LA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/24/2019
Last updated
08/26/2021
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