Doctor Name: | KIMELA LEWIS |
NPI Number: | 1033349469 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 47 Palomba Dr Enfield, CT - 060823868 |
Business Phone Number: | 8602535020 |
Business Fax Number: | 8602535030 |
Mailing Address: | 47 Palomba Dr, ENFIELD |
State: | CT |
Postal Code: | 060823868 |
Phone Number: | 8602535020 |
Fax Number: | 8602535030 |
NPI Enumeration Date: | 07/20/2009 |
NPI Last Update Date: | 07/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |