| NPI | 1023303922 | 
|---|---|
| Former Name | STARLA NICOLE LYLES | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A14833)  | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102203199)  | 
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: CA 20A14833)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-20 | 
| Last Update Date | 2021-02-09 |