Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201009052 | MI |
NPI | 1003297862 |
---|---|
Provider Name | Brittany Lynn Lewis |
First Address | Saginaw, MI 48602-4727 |
Second Address | Saginaw, MI 48602-4727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2015 |
Last Update Date | 17/03/2018 |