Provider Demographics
NPI:1326604042
Name:LEWIS, ABBY MARIE (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:ABBY
Middle Name:MARIE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 OLD NEWPORT ST
Mailing Address - Street 2:
Mailing Address - City:NANTICOKE
Mailing Address - State:PA
Mailing Address - Zip Code:18634-1327
Mailing Address - Country:US
Mailing Address - Phone:570-735-7300
Mailing Address - Fax:
Practice Address - Street 1:147 OLD NEWPORT ST
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-1327
Practice Address - Country:US
Practice Address - Phone:570-735-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant