Individual
JESSICA LEWALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
122 W CENTER ST, FOSTORIA, OH 44830-2201
(419) 435-0204
(419) 436-9846
Mailing address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5177
(419) 557-5179
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.1200728
OH
Other
Enumeration date
10/15/2013
Last updated
10/16/2013
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