Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | PY 241 | NV |
NPI | 1043387012 |
---|---|
Provider Name | Dr. Michael John Lewandowski |
First Address | Reno, NV 89519-0907 |
Second Address | Reno, NV 89511-3027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 12/03/2010 |