Individual
HEATHER LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
199 BRIDGEPORT DR, HALF MOON BAY, CA 94019-4236
(773) 396-8085
Mailing address
199 BRIDGEPORT DR, HALF MOON BAY, CA 94019-4236
(773) 396-8085
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 1475
CA
Other
Enumeration date
03/26/2011
Last updated
03/26/2011
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