Healthcare Provider Details

I. General information

NPI: 1730480260
Provider Name (Legal Business Name): BILLIE JO LEWIS L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2010
Last Update Date: 07/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 STAN AVE APT 10
NEW STANTON PA
15672-9464
US

IV. Provider business mailing address

115 STAN AVE APT 10
NEW STANTON PA
15672-9464
US

V. Phone/Fax

Practice location:
  • Phone: 724-600-9726
  • Fax:
Mailing address:
  • Phone: 724-600-9726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006997
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: