Provider Demographics
NPI:1225839160
Name:LEWIS, MICHELLE ANNE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANNE
Last Name:LEWIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FREDERICK DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3746
Mailing Address - Country:US
Mailing Address - Phone:845-705-3648
Mailing Address - Fax:845-705-3648
Practice Address - Street 1:3 FREDERICK DR
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-3746
Practice Address - Country:US
Practice Address - Phone:845-705-3648
Practice Address - Fax:845-705-3648
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant