Most Relevant Information
Provider Data
| NPI Number: | 1003584103 |
| Provider Name: | GEOFFREY SCOTT LEWIS CDCA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/02/2021 |
| Last Updated: | 09/02/2021 |
Provider Practice Location
84 E MOUND ST
JACKSON
OH
456401226
Practice Location Phone/Fax
| Phone: | 7405773834 |
| Fax: |
Provider Mailing Location
84 E MOUND ST
JACKSON
OH
456401226
Provider Mailing Phone/Fax
| Phone: | 7405773834 |
| Fax: |