Individual
KIESHIA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 EARL RUDDER FRWY SUITE 1200, COLLEGE STATION, TX 77845
(979) 307-5850
Mailing address
305 NE LOOP 820;, BUSINESS TOWER 1, SUITE 200, HURST, TX 76053
(817) 292-8787
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213291
TX
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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