Provider Information for 1265557375
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Mrs. TERESA LYNN LEWIS LCSW
Sex: Female
NPI: 1265557375
Last Updated: 2012-08-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1265557375 | ||||||||||||
| Enumeration Date | 2007-03-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 528 BETHEL, AK 99559-0528 United States Phone: 907-543-6199 | Fax: | ||||||||||||
| Primary Practice Address | 829 CHIEF EDDIE HOFFMAN HWY BETHEL, AK 99559 United States Phone: 907-543-6199 | Fax: | ||||||||||||
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