Individual
TYNEISHA TIERRA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1509 N PIERCE ST, LITTLE ROCK, AR 72207-5203
(150) 131-3597
Mailing address
1509 N PIERCE ST, LITTLE ROCK, AR 72207-5203
(150) 131-3597
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/05/2021
Last updated
04/05/2021
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