Provider Demographics
NPI:1487831178
Name:LEWIS, ADRIANNE M (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANNE
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 OLD BARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CRARYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12521-5247
Mailing Address - Country:US
Mailing Address - Phone:518-851-7241
Mailing Address - Fax:
Practice Address - Street 1:136 OLD BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:CRARYVILLE
Practice Address - State:NY
Practice Address - Zip Code:12521-5247
Practice Address - Country:US
Practice Address - Phone:518-851-7241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008072-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist