Doctor Name: | CRYSTAL FAWN LEWIS |
NPI Number: | 1558683979 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CM |
License Number: | |
Business Practice Address: | 112 Mckinley Ave Chandler, OK - 748341622 |
Business Phone Number: | 4052583040 |
Business Fax Number: | 4052405008 |
Mailing Address: | 112 Mckinley Ave, CHANDLER |
State: | OK |
Postal Code: | 748341622 |
Phone Number: | 4052583040 |
Fax Number: | 4052405008 |
NPI Enumeration Date: | 02/26/2010 |
NPI Last Update Date: | 02/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |