Provider Demographics
NPI:1386944858
Name:LEWIS, NATALIE DAWN (MS CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:NATALIE
Middle Name:DAWN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 OFARRELL ST
Mailing Address - Street 2:APT. 612
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-5298
Mailing Address - Country:US
Mailing Address - Phone:415-913-7890
Mailing Address - Fax:
Practice Address - Street 1:1335 YORI AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2726
Practice Address - Country:US
Practice Address - Phone:510-543-9075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-2470235Z00000X
CA17879235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist