Provider Demographics
NPI:1194041715
Name:LEWIS, DEBRA ELAINE (CAS)
Entity Type:Individual
Prefix:MISS
First Name:DEBRA
Middle Name:ELAINE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2302 MARTIN L KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-4135
Mailing Address - Country:US
Mailing Address - Phone:559-268-9559
Mailing Address - Fax:559-268-9500
Practice Address - Street 1:2302 MARTIN L KING JR BLVD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-4135
Practice Address - Country:US
Practice Address - Phone:559-268-9559
Practice Address - Fax:559-268-9500
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)