Individual
TANISHA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
860 MELROSE AVE, BRONX, NY 10451-4443
(917) 473-6996
Mailing address
253 MALDEN PL # A60, STATEN ISLAND, NY 10306-4603
(347) 898-5792
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
110804
NY
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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