Individual
ISIDORA IZZY LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
TX
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
405300000X
Prevention Professional
CERTIFICATE
TX
Other
Enumeration date
12/05/2022
Last updated
02/08/2023
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