Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS009082L | PA |
Y | 103T00000X | Psychologist | PS009082L | PA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PS009082L | PA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PS009082L | PA |
NPI | 1174997464 |
---|---|
Provider Name | Dr. D'arcy Lyness |
First Address | Wayne, PA 19087-4811 |
Second Address | Wayne, PA 19087-3330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2015 |
Last Update Date | 24/11/2015 |