Doctor Name: | COLLEEN POLLOCK LEWIS |
NPI Number: | 1316347230 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 3654257 |
Business Practice Address: | 5307 Cristo Dr Ne Rockford, MI - 493418814 |
Business Phone Number: | 6164501802 |
Business Fax Number: | 8662183441 |
Mailing Address: | 5307 Cristo Dr Ne, ROCKFORD |
State: | MI |
Postal Code: | 493418814 |
Phone Number: | 6164501802 |
Fax Number: | 8662183441 |
NPI Enumeration Date: | 08/27/2014 |
NPI Last Update Date: | 08/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3654257 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |