Individual
JUSTIN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 W BROADWAY STE D, FARMINGTON, NM 87401-5638
(505) 326-2695
Mailing address
314 N AUBURN AVE, FARMINGTON, NM 87401-5839
(505) 326-2695
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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