Provider Demographics
NPI:1548143324
Name:LEWIS, SHAVON CHRISTINE
Entity type:Individual
Prefix:
First Name:SHAVON
Middle Name:CHRISTINE
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 1:9700 MANAHOAC CIR APT 304
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2622
Mailing Address - Country:US
Mailing Address - Phone:540-419-7701
Mailing Address - Fax:
Practice Address - Street 1:7565 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22551-2706
Practice Address - Country:US
Practice Address - Phone:540-582-7583
Practice Address - Fax:540-582-8825
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist