MEDICARE: DONNA LEWIS

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1205580214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA LEWIS

Provider Business Mailing Address
First Line	:	2401 CAPE ARBOR DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1537
Country	:	US
Telephone Number	:	619-395-2486
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 CAPE ARBOR DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1537
Country	:	US
Telephone Number	:	619-395-2486
Fax Number	:

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

Provider Enumeration Date	:	02/08/2022
Last Update Date	:	02/08/2022

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Directions to “ DONNA LEWIS ” Practice Location

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