Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-17-7836 | NC |
NPI | 1043732704 |
---|---|
Provider Name | Mrs. Lindsay Faith Fields Lewis |
First Address | Raleigh, NC 27607-5237 |
Second Address | Raleigh, NC 27607-5237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2017 |
Last Update Date | 13/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1194858761 | NPI -MEREDITH AUTISM PROGRAM (01) | NC |