Individual
JESSICA MARIE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA, LBA
Contact information
Practice address
4200 S WESTNEDGE AVE, KALAMAZOO, MI 49008-3208
(269) 459-7821
Mailing address
4200 S WESTNEDGE AVE, KALAMAZOO, MI 49008-3208
(692) 459-7821
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-17-26151
—
103K00000X
Behavior Analyst
Primary
7401000643
MI
Other
Enumeration date
08/16/2015
Last updated
10/28/2021
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