Individual
MARK HENRY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.A.D.C.
Contact information
Practice address
217 N UNION AVE, FERGUS FALLS, MN 56537-2127
(218) 739-9084
(218) 739-0518
Mailing address
217 N UNION AVE, FERGUS FALLS, MN 56537-2127
(218) 739-9084
(218) 739-0518
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302705
MN
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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