Healthcare Provider Details

I. General information

NPI: 1134351455
Provider Name (Legal Business Name): CHRISTEL MONIKA LEWIS-BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTEL LEWIS

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 PLAZA DR
SCARBOROUGH ME
04074-8996
US

IV. Provider business mailing address

7 PLAZA DR
SCARBOROUGH ME
04074-8996
US

V. Phone/Fax

Practice location:
  • Phone: 207-883-1211
  • Fax: 207-883-1224
Mailing address:
  • Phone: 207-883-1211
  • Fax: 207-883-1224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT1640
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: