Individual
DR. OMETHA O LEWIS-JACK
Active
Individual
DR. OMETHA O LEWIS-JACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
PSY1835
DC
103TC0700X
Clinical Psychologist
Primary
PSY1835
DC
103TF0000X
Family Psychologist
PSY1835
DC
103TF0200X
Forensic Psychologist
PSY1835
DC
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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