Individual
DEERICKA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6417 US 60, ASHLAND, KY 41144-1187
(606) 475-0200
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
299755
KY
Other
Enumeration date
05/13/2024
Last updated
06/13/2025
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