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Individual

AMIRA SHANNON LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
754 E 151ST ST, BRONX, NY 10455-3267
(718) 734-2539
(917) 473-6970
Mailing address
311 E 175TH ST, BRONX, NY 10457-5859
(718) 960-7522
(718) 583-6439

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
118764
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
551075686
DRIVER LICENSE
NY
Enumeration date
03/23/2023
Last updated
03/23/2023
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