Individual
MS. ANTIONETTE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2100 WESTSHORE DR STE 117, CUMMING, GA 30041-9277
(770) 878-3175
Mailing address
7560 RAMBLING VALE, CUMMING, GA 30028-6605
(770) 858-3181
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-22-221530
GA
171W00000X
Contractor
RBT-22-221530
GA
Other
Enumeration date
08/28/2024
Last updated
09/09/2024
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