Individual
KELLY RITA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2464 FORTUNE DR, LEXINGTON, KY 40509-4260
(859) 899-9200
Mailing address
179 E LOUDON AVE, LEXINGTON, KY 40505-3575
(330) 410-8499
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/07/2021
Last updated
03/29/2024
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