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General NPI Number Information
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NPI Number | 1063836369
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Entity Type | Organization
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Legal Business Name | MARCIA LEWIS
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 833 ASPEN PEAK LOOP #225
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City | HENDERSON
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State | NV
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Zip | 89011-1803
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Country | US
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Telephone | 916-284-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 833 ASPEN PEAK LOOP #225
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City | HENDERSON
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State | NV
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Zip | 89011
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Country | US
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Telephone | 916-284-0404
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Fax |
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Authorized Official
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Title or Position | BASIC SKILLS TRAINER
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Name | MARCIA KAY LEWIS
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Credential |
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Telephone | 916-284-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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