Individual
DR. THERESA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4917 WATERS EDGE DR STE 220, RALEIGH, NC 27606-2459
(919) 622-1303
Mailing address
PO BOX 1955, CARY, NC 27512-1955
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2866
NC
103TC1900X
Counseling Psychologist
—
—
103TH0004X
Health Psychologist
2866
NC
103TH0100X
Health Service Psychologist
Primary
2866
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045WX
BCBS
NC
Enumeration date
01/02/2008
Last updated
03/17/2018
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