Individual
KIMBERLY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2404 WISE RD, CONWAY, SC 29526-5521
(843) 365-8884
Mailing address
4108 CAROLINA COMMERCIAL DRIVE SUITE 2, MYRTLE BEACH, SC 29579-4223
(843) 469-1252
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6992
SC
Other
Enumeration date
02/21/2018
Last updated
10/12/2020
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