Lisanna Star Lewis

NPI #1700472412 in Gladwin, Michigan

Provider Information

NPI Number: 1700472412
Entity Type: Individual
Name: Lisanna Star Lewis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 16, 2020
Last Updated: Apr 13, 2022

Practice Location

Address: 1234 W CEDAR AVE STE B
City: Gladwin
State: Michigan
ZIP Code: 48624-1818
Phone: (989) 423-0971

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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