Individual
TONIA SUE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
115 BRIERTON LN, FESTUS, MO 63028-1972
(636) 931-0300
Mailing address
8746 LITTLE DEER DR, DITTMER, MO 63023-3606
(636) 428-9510
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2019037058
MO
202C00000X
Independent Medical Examiner Physician
2019037058
MO
Other
Enumeration date
10/02/2019
Last updated
10/04/2019
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