Individual ProviderMirra Lynn LewisBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address7542 Widgeon Way, Fair Oaks, CA 95628-5731(916) 517-8783PECOS EnrollmentBased on the most recent information from CMS, provider Mirra Lynn Lewis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1457861197Provider TypeIndividualFull NameLewis, Mirra LynnGenderFemaleSole ProprietorNoEnumeration Date10/9/2017Last Updated10/9/2017Contact InformationPractice LocationPractice Address7542 Widgeon Way, Fair Oaks, CA 95628-5731Phone(916) 517-8783FaxUnlisted FaxMailing LocationMailing Address7542 Widgeon Way, Fair Oaks, CA 95628-5731Phone(916) 517-8783FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer