Individual
LAVONNE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
929 MARION ST, DAYTONA BEACH, FL 32114-6005
(386) 307-9938
Mailing address
929 MARION ST, DAYTONA BEACH, FL 32114-6005
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/21/2020
Last updated
11/06/2020
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