Individual
DEDRA Y LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
12650 SHOREWOOD LN, VICTORVILLE, CA 92392-0518
(760) 947-4069
Mailing address
12650 SHOREWOOD LN, VICTORVILLE, CA 92392-0518
(760) 947-4069
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
03/17/2010
Last updated
03/17/2010
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