Individual
SHANIA JENA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8517 LESLIE CT, FREDERICKSBURG, VA 22407-8728
(804) 356-9031
Mailing address
8517 LESLIE CT, FREDERICKSBURG, VA 22407-8728
(804) 356-9031
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
A67325453
VA
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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