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NPI Code Detail

MEDICARE: LEONA LEWIS

MEDICARE: LEONA 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
1101YP2500XProfessional CounselorE0002677OH

General Provider Information

NPI Number : 1720078777
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEONA LEWIS
Provider Business Mailing Address
First Line : PO BOX 10015
Second Line :
City : TOLEDO
State : OH
Zip : 43699-0015
Country : US
Telephone Number : 419-693-0631
Fax Number :
Provider Business Practice Location Address
First Line : 1425 STARR AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43605-2456
Country : US
Telephone Number : 419-693-0631
Fax Number : 419-936-7606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 10/16/2007

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Directions to “ LEONA LEWIS ” Practice Location

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