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General NPI Number Information
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NPI Number | 1760057285
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Entity Type | Individual
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Provider Name | ANDREW LEWIS BCBA
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Gender | Male
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 5465 ABLE CT
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City | MOBILE
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State | AL
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Zip | 36693-3100
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Country | US
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Telephone | 251-644-5938
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Fax |
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Provider Business Mailing Address
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Address Line | 11401 GRAND TERRACE CIR S
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City | GRAND BAY
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State | AL
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Zip | 36541-7321
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Country | US
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Telephone | 251-422-7966
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 2024-078
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License Number State | AL
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