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NPI Code Detail

MEDICARE: DR. LAURA JEAN LEWIS PH.D.

MEDICARE:  DR. LAURA JEAN LEWIS  PH.D.
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
1163W00000XRegistered Nurse180943OH
2101Y00000XCounselorE 0004386OH
3103T00000XPsychologist6498OH

General Provider Information

NPI Number : 1588998595
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA JEAN LEWIS PH.D.
Provider Business Mailing Address
First Line : 3454 OAK ALLEY CT STE 200
Second Line :
City : TOLEDO
State : OH
Zip : 43606-1370
Country : US
Telephone Number : 419-460-0413
Fax Number : 844-443-0075
Provider Business Practice Location Address
First Line : 3454 OAK ALLEY CT STE 200
Second Line :
City : TOLEDO
State : OH
Zip : 43606-1370
Country : US
Telephone Number : 419-460-0413
Fax Number : 844-443-0075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2009
Last Update Date : 01/11/2021

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Directions to “ DR. LAURA JEAN LEWIS PH.D.” Practice Location

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