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General NPI Number Information
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NPI Number | 1174005474
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Entity Type | Individual
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Provider Name | HEATHER LYNN LEWIS OT
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Gender | Female
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 133 AVIATION RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-8206
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Country | US
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Telephone | 518-798-0533
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WELLINGTON CT
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-8585
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Country | US
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Telephone | 518-428-8718
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 022431-1
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License Number State | NY
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