MEDICARE: MS. JUDITH P. LYONS MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	554-124	WI

General Provider Information

NPI Number	:	1881804219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH P. LYONS MS

Provider Business Mailing Address
First Line	:	3308 GLACIER RIDGE RD
Second Line	:
City	:	MIDDLETON
State	:	WI
Zip	:	53562-1766
Country	:	US
Telephone Number	:	608-833-3315
Fax Number	:

Provider Business Practice Location Address
First Line	:	3308 GLACIER RIDGE RD
Second Line	:
City	:	MIDDLETON
State	:	WI
Zip	:	53562-1766
Country	:	US
Telephone Number	:	608-833-3315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	02/15/2026

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