Individual
KATHERINE E LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
7000 E GENESEE ST BLDG C, FAYETTEVILLE, NY 13066-1131
(315) 539-7974
Mailing address
7000 E GENESEE ST BLDG C, FAYETTEVILLE, NY 13066-1131
(315) 539-7974
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
011139
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03030577
—
NY
Enumeration date
07/11/2008
Last updated
04/30/2024
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