Individual
DEBORAH LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LMSW
Contact information
Practice address
1070 HILINE RD, 210, POCATELLO, ID 83201-2947
(208) 478-9081
(208) 478-4999
Mailing address
2420 E 25TH ST, IDAHO FALLS, ID 83404-7549
(208) 542-1026
(208) 528-2945
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LMSW-26974
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW-29048
STATE LICENSE
ID
Enumeration date
09/26/2006
Last updated
06/17/2013
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