Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003344433 |
---|---|
Provider Name | Hillary Jo Lewis |
First Address | Rochester, PA 15074-1149 |
Second Address | Columbia, MD 21046-2534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2017 |
Last Update Date | 30/05/2017 |