Individual
JENNIFER LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
416 W ETHEL AVE, LOMBARD, IL 60148-3204
(630) 613-9221
Mailing address
416 W ETHEL AVE, LOMBARD, IL 60148-3204
(630) 613-9221
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178010059
IL
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/23/2014
Last updated
08/23/2014
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