Datra Lewis

NPI #1013425958 in Virginia Beach, Virginia

Provider Information

NPI Number: 1013425958
Entity Type: Individual
Name: Datra Lewis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 12, 2018
Last Updated: Jan 12, 2018

Practice Location

Address: 4490 HOLLAND OFFICE PARK OFC PARK101
City: Virginia Beach
State: Virginia
ZIP Code: 23452-1177
Phone: (757) 639-2218

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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