Provider Demographics
NPI:1093869737
Name:LEW, MARCI
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:
Last Name:LEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 W KNOX ST
Mailing Address - Street 2:APT. A
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4145
Mailing Address - Country:US
Mailing Address - Phone:919-286-4551
Mailing Address - Fax:919-932-7215
Practice Address - Street 1:2110 W KNOX ST
Practice Address - Street 2:APT. A
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4145
Practice Address - Country:US
Practice Address - Phone:919-286-4551
Practice Address - Fax:919-932-7215
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist