Individual
BEVERLY LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 W RED MESA TRL, SAN TAN VALLEY, AZ 85143-6228
(480) 579-6590
(602) 896-2580
Mailing address
2320 W PEORIA AVE, SUITE B147, PHOENIX, AZ 85029-4753
(602) 283-7117
(602) 896-2580
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
BH4850
AZ
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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