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General NPI Number Information
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NPI Number | 1578296810
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Entity Type | Individual
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Provider Name | EMILY LEWIS PHD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 3725 W 4100 S STE 250
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City | WEST VALLEY CITY
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State | UT
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Zip | 84120-5434
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Country | US
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Telephone | 801-582-5534
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Fax |
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Provider Business Mailing Address
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Address Line | 425 W 200 N UNIT 289
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City | SALT LAKE CITY
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State | UT
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Zip | 84103-2040
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Country | US
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Telephone | 801-582-5534
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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