Provider Demographics
NPI:1417152778
Name:LEWIS, LAMESHA LEE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAMESHA
Middle Name:LEE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MRS
Other - First Name:LAMESHA
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:PO BOX 321083
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-1083
Mailing Address - Country:US
Mailing Address - Phone:601-668-3230
Mailing Address - Fax:
Practice Address - Street 1:190 BRIDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-8480
Practice Address - Country:US
Practice Address - Phone:601-668-3230
Practice Address - Fax:601-992-7337
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2891235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist