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Individual

ROTASHA LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1919 E SECOND ST, EDMOND, OK 73034
(404) 723-1306
Mailing address
1919 E 2ND ST, EDMOND, OK 73034-6219

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
04/21/2015
Last updated
04/21/2015
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