Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1316200421 |
---|---|
Provider Name | Mrs. Loralett Debra Lyons |
First Address | Norman, OK 73069-4076 |
Second Address | Norman, OK 73069-4076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2012 |
Last Update Date | 22/06/2012 |