NPI | 1265809917 |
---|---|
Former Name | SHELBIE LYON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KY 254243) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 165322) |
1041C0700X Social Worker Clinical (Licence: KY 252401) | |
Enumeration Date | 2015-08-28 |
Last Update Date | 2019-07-05 |