Provider Demographics
NPI:1093498131
Name:LEWIS, LA'VELL (RBT)
Entity Type:Individual
Prefix:
First Name:LA'VELL
Middle Name:
Last Name:LEWIS
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 PECAN CT
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-3233
Mailing Address - Country:US
Mailing Address - Phone:156-767-4062
Mailing Address - Fax:
Practice Address - Street 1:324 PECAN CT
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-3233
Practice Address - Country:US
Practice Address - Phone:567-674-0626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician