| Doctor Name: | MS. MARY LOUISE LEWIS |
| NPI Number: | 1003834417 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LAC |
| License Number: | 831 |
| Business Practice Address: | 3200 Concordia Ave Monroe, LA - 712015113 |
| Business Phone Number: | 3183625188 |
| Business Fax Number: | |
| Mailing Address: | 122 Mohawk Cir, WEST MONROE |
| State: | LA |
| Postal Code: | 712918142 |
| Phone Number: | 3183968112 |
| Fax Number: | |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 831 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |