Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | M-11848 | NM |
NPI | 1003324278 |
---|---|
Provider Name | Lyric Lawson-Parks |
First Address | Owensboro, KY 42302-1637 |
Second Address | Albuquerque, NM 87102-2360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2018 |
Last Update Date | 22/10/2021 |