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1902164858
KYLE L LIDGE
BRANDON, FL
NPI
1902164858
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH11209)
Enumeration Date
2012-04-29
Last Update Date
2012-04-29
Business Address
-- KYLE L LIDGE LMHC
1117 VINETREE DR
BRANDON, FL 33510-2087
Phone number: 813-703-5366
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Mailing Address
-- KYLE L LIDGE LMHC
1109 N PARSONS AVE
BRANDON, FL 33510-3105
Phone number: 813-662-4214
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