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Individual

BROOKE LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
5163 ROSWELL RD, ATLANTA, GA 30342-2206
(813) 679-7277
Mailing address
340 HONEYSUCKLE TER, WOODSTOCK, GA 30188-1758

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
GA
106S00000X
Behavior Technician

Other

Enumeration date
01/22/2020
Last updated
01/22/2020
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