Individual
DR. JONATHAN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6425 NICOLLET AVE, RICHFIELD, MN 55423-1675
(612) 861-1675
Mailing address
6425 NICOLLET AVE, RICHFIELD, MN 55423-1675
(612) 861-1675
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6274
MN
Other
Enumeration date
09/17/2018
Last updated
10/03/2018
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