Individual
DR. JESSE F LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3540 WHEELER RD STE 415, AUGUSTA, GA 30909-1888
(706) 738-7000
Mailing address
3540 WHEELER RD STE 415, AUGUSTA, GA 30909-1888
(706) 738-7000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
000477
GA
103TC2200X
Clinical Child & Adolescent Psychologist
000477
GA
Other
Enumeration date
01/10/2007
Last updated
08/20/2007
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