Provider Demographics
NPI:1023842325
Name:LEWIS, SHARNICE NACHELLE
Entity type:Individual
Prefix:
First Name:SHARNICE
Middle Name:NACHELLE
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 1:1113 WILLINGER CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-5505
Mailing Address - Country:US
Mailing Address - Phone:410-936-9022
Mailing Address - Fax:
Practice Address - Street 1:1113 WILLINGER CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5505
Practice Address - Country:US
Practice Address - Phone:410-936-9022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician