Individual
CECELYN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3007 HARBOR LN N STE 1200, PLYMOUTH, MN 55447-5138
(612) 445-8314
Mailing address
1461 73RD AVE NE APT 204, FRIDLEY, MN 55432-3719
(763) 400-1499
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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