Individual
MS. VANESSA LORRAINE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
6401012459
Contact information
Practice address
16250 NORTHLAND DR, SOUTHFIELD, SOUTHFIELD, MI 48075-5205
(313) 528-1402
(313) 447-2277
Mailing address
16250 NORTHLAND DR, SOUTHFIELD, SOUTHFIELD, MI 48075-5205
(313) 528-1402
(313) 447-2277
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401012459
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12739692
MERIDIAN
MI
Enumeration date
07/29/2014
Last updated
07/29/2014
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