MEDICARE: CARI L LEWIS SLPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	SLPA12417	AZ

General Provider Information

NPI Number	:	1083230627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARI L LEWIS SLPA

Provider Business Mailing Address
First Line	:	273 W WILLIAM CAREY ST
Second Line	:
City	:	CORONA DE TUCSON
State	:	AZ
Zip	:	85641-2531
Country	:	US
Telephone Number	:	575-313-7679
Fax Number	:

Provider Business Practice Location Address
First Line	:	273 W WILLIAM CAREY ST
Second Line	:
City	:	CORONA DE TUCSON
State	:	AZ
Zip	:	85641-2531
Country	:	US
Telephone Number	:	575-313-7679
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2020
Last Update Date	:	06/19/2020

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Directions to “ CARI L LEWIS SLPA” Practice Location

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