Individual
PATRICIA MARIE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1852 W GRAND BLVD, DETROIT, MI 48208-1006
(313) 894-8444
(313) 894-5542
Mailing address
1852 W GRAND BLVD, DETROIT, MI 48208-1006
(313) 894-8444
(313) 894-5542
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
L528696
MI
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38-1917278
—
MI
Enumeration date
09/16/2015
Last updated
09/16/2015
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