Healthcare Provider Details

I. General information

NPI: 1558993444
Provider Name (Legal Business Name): ZANET LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 ONEAL LN STE B
BATON ROUGE LA
70816-9315
US

IV. Provider business mailing address

2380 ONEAL LN STE B
BATON ROUGE LA
70816-9315
US

V. Phone/Fax

Practice location:
  • Phone: 225-361-0219
  • Fax:
Mailing address:
  • Phone: 225-361-0219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC10142
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: