Individual
ASHLEY ELAINAH LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3207 LOUISE ST, ROCKFORD, IL 61103-3020
(815) 621-0497
Mailing address
PO BOX 639561, CINCINNATI, OH 45263-9561
(844) 247-7222
(847) 584-2604
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58073
IL
Other
Enumeration date
11/06/2018
Last updated
03/02/2022
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