Individual
MS. TINESE LASHAWN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 ALMA BLVD, MERRITT ISLAND, FL 32953-4345
(321) 453-0202
Mailing address
1090 LORING DR, APT G, MERRITT ISLAND, FL 32953-2559
(321) 544-2235
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13940
FL
Other
Enumeration date
10/18/2015
Last updated
10/18/2015
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