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General NPI Number Information
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NPI Number | 1497600845
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Entity Type | Individual
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Provider Name | THOMAS LEWIS
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Gender | Male
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 300 CHATILLON RD NE
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City | ROME
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State | GA
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Zip | 30161-4911
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Country | US
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Telephone | 470-473-5920
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Fax | 888-979-8504
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Provider Business Mailing Address
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Address Line | 345 PARKWAY 575
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City | WOODSTOCK
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State | GA
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Zip | 30188-3897
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Country | US
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Telephone | 770-833-5762
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Fax | 888-979-8504
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | GA
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