Individual
CARRIE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1049 1ST CAPITOL DR, SAINT CHARLES, MO 63301-1952
(314) 341-0170
Mailing address
1049 1ST CAPITOL DR, SAINT CHARLES, MO 63301-1952
(314) 341-0170
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2019045859
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490080412
—
MO
Enumeration date
01/12/2011
Last updated
04/06/2020
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