Provider Demographics
NPI:1760991772
Name:LEWIS, KATHRYNE LOUISE
Entity Type:Individual
Prefix:MRS
First Name:KATHRYNE
Middle Name:LOUISE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 WALLACETON MORRISDALE HWY
Mailing Address - Street 2:PO BOX 38
Mailing Address - City:WALLACETON
Mailing Address - State:PA
Mailing Address - Zip Code:16876
Mailing Address - Country:US
Mailing Address - Phone:814-553-6805
Mailing Address - Fax:
Practice Address - Street 1:2770 WALLACETON MORRISDALE HWY
Practice Address - Street 2:
Practice Address - City:WALLACETON
Practice Address - State:PA
Practice Address - Zip Code:16876
Practice Address - Country:US
Practice Address - Phone:814-553-6805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor