Provider Demographics
NPI:1124250865
Name:LEWIS, JAIME LYNN
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LYNN
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:PO BOX 10219
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-5219
Mailing Address - Country:US
Mailing Address - Phone:808-634-5253
Mailing Address - Fax:
Practice Address - Street 1:77 MOHOULI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4181
Practice Address - Country:US
Practice Address - Phone:808-961-5166
Practice Address - Fax:808-934-0071
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst