| NPI | 1104268549 |
|---|---|
| Former Name | LAREN S LYDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 8838) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS 4508) |
| 1041C0700X Social Worker Clinical (Licence: MO 201600164) | |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2017-06-19 |