Provider Demographics
NPI:1740028273
Name:LEWIS, ZENIYA SUNSHAE (RBT)
Entity type:Individual
Prefix:
First Name:ZENIYA
Middle Name:SUNSHAE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MS
Other - First Name:ZENIYA
Other - Middle Name:SUNSHAE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1110 13TH ST STE D6201
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2246
Mailing Address - Country:US
Mailing Address - Phone:706-315-8059
Mailing Address - Fax:
Practice Address - Street 1:1110 13TH ST STE D6201
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2246
Practice Address - Country:US
Practice Address - Phone:706-315-8059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician