Individual
SHANTELLE YVONNETTE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
7108 WASHINGTON ST SW STE B, COVINGTON, GA 30014-3417
(470) 236-2437
Mailing address
13152 GREYWOLF LN, COVINGTON, GA 30014-9017
(678) 656-5907
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79416
GA
Other
Enumeration date
02/22/2025
Last updated
02/28/2025
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