Provider Demographics
NPI:1134351455
Name:LEWIS-BROWN, CHRISTEL MONIKA
Entity type:Individual
Prefix:
First Name:CHRISTEL
Middle Name:MONIKA
Last Name:LEWIS-BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTEL
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8996
Mailing Address - Country:US
Mailing Address - Phone:207-883-1211
Mailing Address - Fax:207-883-1224
Practice Address - Street 1:7 PLAZA DR
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-8996
Practice Address - Country:US
Practice Address - Phone:207-883-1211
Practice Address - Fax:207-883-1224
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1640225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist