Provider Demographics
NPI:1922617042
Name:LEWIS, BARBARA ANN (BCBA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:DININO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 E PRATT ST FL 8
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3180
Mailing Address - Country:US
Mailing Address - Phone:201-966-2648
Mailing Address - Fax:
Practice Address - Street 1:400 E PRATT ST FL 8
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3180
Practice Address - Country:US
Practice Address - Phone:201-966-2648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty