Individual
DAVID LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 BAKER BLVD STE 5A, FAIRLAWN, OH 44333-3603
(216) 772-3188
Mailing address
674 HICKORY GROVE CT, STREETSBORO, OH 44241-4550
(330) 715-2673
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
173043
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.177035
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0411945
—
OH
Enumeration date
07/29/2020
Last updated
12/29/2021
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