Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1033682133 |
---|---|
Provider Name | Lynnchetta Latonish Lewis |
First Address | Eunice, LA 70535-6104 |
Second Address | Opelousas, LA 70570-6029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2019 |
Last Update Date | 15/01/2019 |