Individual
JACKWLYN M LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
200 N 34TH ST, NORFOLK, NE 68701-3197
(402) 371-3044
Mailing address
112 GOLD STRIKE DR APT 1, NORFOLK, NE 68701-2956
(660) 888-3410
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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