Individual
MRS. JENNIFER JOAN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1117 THORNBERRY DR, CLARKSVILLE, TN 37043-5631
(912) 547-9772
Mailing address
1117 THORNBERRY DR, CLARKSVILLE, TN 37043-5631
(912) 547-9772
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-22331
—
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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