Individual
LARESHA RENEE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3841 SAGEBRIAR DR, BRYAN, TX 77802-6107
(979) 406-6018
Mailing address
3841 SAGEBRIAR DR, BRYAN, TX 77802-6107
(979) 406-6018
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
5434
TX
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/06/2021
Last updated
02/03/2023
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