MEDICARE: RHEANNE SARENE LEWIS M.S.

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	146011816	IL
2	235Z00000X	Speech-Language Pathologist	9603	MN

General Provider Information

NPI Number	:	1457784514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHEANNE SARENE LEWIS M.S.

Provider Business Mailing Address
First Line	:	3221 SAINT MARGARET DR
Second Line	:
City	:	GOLDEN VALLEY
State	:	MN
Zip	:	55422-3847
Country	:	US
Telephone Number	:	309-339-3847
Fax Number	:

Provider Business Practice Location Address
First Line	:	3221 SAINT MARGARET DR
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55422-3847
Country	:	US
Telephone Number	:	309-339-3847
Fax Number	:

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

Provider Enumeration Date	:	08/13/2013
Last Update Date	:	01/24/2020

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Directions to “ RHEANNE SARENE LEWIS M.S.” Practice Location

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