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Latasha Nicole Lyons
Professional Counselor in Mount Vernon, Illinois
NPI 1639790264

Latasha Nicole Lyons is a Professional Counselor based in Mount Vernon, IL and is specialized in Professional. Latasha Nicole Lyons practices in Mount Vernon, IL. The NPI Number for Latasha Nicole Lyons is 1639790264 and holds a License No. 178.015569 (Illinois).

The current practice location address for Latasha Nicole Lyons is 1004 Mulligan Dr, Mount Vernon, IL and can be reached out via phone at 708-238-1876.

Location: 1004 Mulligan Dr, Mount Vernon, IL, 62864-2099
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639790264
Provider Name
Latasha Nicole Lyons
Credential
Provider Entity Type
Individual
Gender
Female
Address
1004 Mulligan Dr, Mount Vernon, IL, 62864-2099
Phone Number
708-238-1876
Fax Number
Provider Enumeration Date
05/05/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1004 Mulligan Dr
City
Mount Vernon
State
Illinois
Zip
62864-2099
Phone Number
708-238-1876
Fax Number
person
Provider Business Mailing Address Details
Address
1004 Mulligan Dr
City
Mount Vernon
State
Illinois
Zip
62864-2099
Phone Number
708-238-1876
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
178.015569 (Illinois)
Definition
Definition to come...
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