Individual
MARY LEE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6250 OLD CANTON RD STE 130, JACKSON, MS 39211-2946
(601) 956-7280
(601) 977-6244
Mailing address
PO BOX 2153 DEPT 1947, BIRMINGHAM, AL 35287-0001
(601) 292-4562
(601) 974-6237
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S4467
MS
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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