Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 162947 | OH |
NPI | 1003335639 |
---|---|
Provider Name | Lisa Lewis |
First Address | Cincinnati, OH 45219-2414 |
Second Address | Hamilton, OH 45011-3455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2017 |
Last Update Date | 06/11/2019 |