Doctor Name: | MRS. MARY RM LEWIS |
NPI Number: | 1144370198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | LH00009721 |
Business Practice Address: | 101 S Main St Suite B Montesano, WA - 985633727 |
Business Phone Number: | 3602492332 |
Business Fax Number: | 3602492352 |
Mailing Address: | 101 S Main St, Suite B MONTESANO |
State: | WA |
Postal Code: | 985633727 |
Phone Number: | 3602492332 |
Fax Number: | 3602492352 |
NPI Enumeration Date: | 01/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH00009721 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |