Individual
DOLLY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 HIGHWAY MM, HANNIBAL, MO 63401-3602
(573) 221-2111
Mailing address
58971 WALNUT PL, NEW LONDON, MO 63459-2636
(573) 795-9550
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2010010214
MO
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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