Provider Demographics
NPI:1710169495
Name:LEWIS, MARIA M (MASTERS OF HR)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MASTERS OF HR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4725 SILVERDENE ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-3505
Mailing Address - Country:US
Mailing Address - Phone:919-877-8613
Mailing Address - Fax:919-877-8613
Practice Address - Street 1:4725 SILVERDENE STREET
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-3505
Practice Address - Country:US
Practice Address - Phone:919-877-8613
Practice Address - Fax:919-877-8613
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-693320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness