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Individual

MS. ISHAKETA MARJON LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3329 W DANBURY DR APT F213, PHOENIX, AZ 85053-1823
(216) 644-1427
Mailing address
17235 N 75TH AVE, GLENDALE, AZ 85308-0831
(480) 812-4789

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
04/21/2026
Last updated
04/28/2026
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