Individual
AMANDA R LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1405 N GREEN MOUNT RD STE 230, O FALLON, IL 62269-3494
(618) 334-5571
(618) 551-8955
Mailing address
1405 N GREEN MOUNT RD STE 230, O FALLON, IL 62269-3494
(618) 334-5571
(618) 551-8955
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.018245
IL
Other
Enumeration date
09/26/2014
Last updated
02/20/2019
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