Individual
BRANDON ANTONIO LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
327 SW C AVE, LAWTON, OK 73501-4016
(580) 280-1988
Mailing address
327 SW C AVE, LAWTON, OK 73501-4016
(580) 280-1988
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200949300A
—
OK
Enumeration date
06/29/2021
Last updated
08/02/2024
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