Provider Demographics
NPI:1003480989
Name:LEWANDROWSKI, COURTNEY (BS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:LEWANDROWSKI
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8028 INDIGO RIDGE TER
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34201-2053
Mailing Address - Country:US
Mailing Address - Phone:941-228-3089
Mailing Address - Fax:
Practice Address - Street 1:8028 INDIGO RIDGE TER
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:FL
Practice Address - Zip Code:34201-2053
Practice Address - Country:US
Practice Address - Phone:941-228-3089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-16
Last Update Date:2021-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician