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General NPI Number Information
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NPI Number | 1124049556
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Entity Type | Individual
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Provider Name | ROXANNE ANGELA LEWIS PHD
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 200 E CAMPUS VIEW BLVD SUITE 200
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City | COLUMBUS
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State | OH
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Zip | 43235-4678
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Country | US
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Telephone | 614-985-3649
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Fax | 614-985-3601
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Provider Business Mailing Address
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Address Line | 387 COUNTY LINE RD W STE 225
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City | WESTERVILLE
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State | OH
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Zip | 43082-6918
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Country | US
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Telephone | 614-985-3649
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Fax | 614-985-3601
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 3428
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3574
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 60009283
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License Number State | WA
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