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Provider Information for 1033632815


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SUANDRIA LEWIS


Sex: Female

NPI: 1033632815
Last Updated: 2024-05-05
Certification Date: 2024-05-05

Details

NameValue
NPI1033632815
Enumeration Date2017-07-24
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 2710 HAYDEN DR
EAST POINT, GA 30344-1056
United States

Phone: 207-726-9677 | Fax:
 
Primary Practice Address 5350 DTC PKWY STE 306
GREENWOOD VILLAGE, CO 80111-2998
United States

Phone: 720-772-6967 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthCOLPC.018191