Individual
AMANDA NICOLE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(615) 474-6727
Mailing address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
114303
—
Other
Enumeration date
01/27/2022
Last updated
02/23/2023
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