Individual
MRS. JILL COLETTE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. LAC, GUIDANCE
Contact information
Practice address
8176 NORTH WESTOVER, JOSEPH CITY, AZ 86032
(928) 288-3307
(928) 288-3309
Mailing address
P.O. BOX 2500, SNOWFLAKE, AZ 85937
(928) 243-1441
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-11268
AZ
101YS0200X
School Counselor
2331144
AZ
Other
Enumeration date
04/23/2007
Last updated
11/16/2009
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