Mirra Lynn Lewis

NPI #1457861197 in Fair Oaks, California

Provider Information

NPI Number: 1457861197
Entity Type: Individual
Name: Mirra Lynn Lewis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Oct 9, 2017
Last Updated: Oct 9, 2017

Practice Location

Address: 7542 WIDGEON WAY
City: Fair Oaks
State: California
ZIP Code: 95628-5731
Phone: (916) 517-8783

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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