Individual
MR. CHARLES RAY LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-8001
(337) 531-3915
Mailing address
1217 APACHE ST, DERIDDER, LA 70634-2700
(337) 463-3175
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C1987
MS
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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