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Individual

MR. LARRY WAYNE LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
94 E PAGES LN # A, CENTERVILLE, UT 84014-2216
(801) 294-0578
Mailing address
155 N FORT LN APT D, LAYTON, UT 84041-3843
(801) 593-0616

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5595450-6004
UT

Other

Enumeration date
12/22/2006
Last updated
07/08/2007
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