Individual
JENNIFER TICKNER LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA-CCC-SLP
Contact information
Practice address
7244 E MAIN ST, REYNOLDSBURG, OH 43068-2014
(614) 501-1020
Mailing address
7244 E MAIN ST, REYNOLDSBURG, OH 43068-2014
(614) 501-1020
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.9763
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235Z00000X
—
OH
Enumeration date
02/10/2014
Last updated
02/07/2018
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