Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000387 | CT |
NPI | 1063668200 |
---|---|
Provider Name | Cheryl Lynn Lyon |
First Address | Waterbury, CT 06708-2517 |
Second Address | Waterbury, CT 06708-2517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2008 |
Last Update Date | 07/08/2008 |