Individual
ANGELLA MARIA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
6511 N RANDWICK RD, PEORIA, IL 61615-2532
(309) 635-5655
Mailing address
6511 N RANDWICK RD, PEORIA, IL 61615-2532
(309) 635-5655
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.014333
IL
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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