Individual
GOLDIE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5157 SCARBROUGH TRL W, STONE MOUNTAIN, GA 30088-4326
(770) 380-9732
Mailing address
5157 SCARBROUGH TRL W, STONE MOUNTAIN, GA 30088-4326
(770) 380-9732
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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