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Individual

IRINA LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3452 LAKE LYNDA DR STE 200, ORLANDO, FL 32817-1481
(407) 308-3912
Mailing address
3452 LAKE LYNDA DR STE 200, ORLANDO, FL 32817-1481
(407) 308-3912

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
32002775A
IN
224Z00000X
Occupational Therapy Assistant
Primary
BOTOTA00212084
KY
224Z00000X
Occupational Therapy Assistant
OTA.06374
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1001016016
KY
Enumeration date
04/04/2016
Last updated
04/04/2016
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