| Doctor Name: | DR. KENT E LEWIS |
| NPI Number: | 1053345645 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D MIN |
| License Number: | 215 |
| Business Practice Address: | 612 Wilson Ave Tullahoma, TN - 37388 |
| Business Phone Number: | 9314558504 |
| Business Fax Number: | 9313932996 |
| Mailing Address: | Po Box 1296, TULLAHOMA |
| State: | TN |
| Postal Code: | 37388 |
| Phone Number: | 9314558504 |
| Fax Number: | 9313932996 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 215 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |