| NPI | 1649759192 |
|---|---|
| Former Name | STEPHANIE LYON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00584100) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 022455) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |