| NPI | 1336216944 |
|---|---|
| Former Name | LORETTA LOUISE LEWIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I-0700266-SUPV) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E-0001762-SUPV) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2012-05-15 |