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General NPI Number Information
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NPI Number | 1528795663
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Entity Type | Organization
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Legal Business Name | LYRICLY BEHAVIORAL WELLNESS
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Dates
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Enumeration Date | 08/08/2022
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 150 MONUMENT ROAD STE 207
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1725
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Country | US
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Telephone | 610-756-1985
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Fax |
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Provider Business Mailing Address
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Address Line | 2803 DEVON LN
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City | DREXEL HILL
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State | PA
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Zip | 19026-2205
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Country | US
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Telephone | 215-927-6417
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Fax |
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Authorized Official
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Title or Position | OWNER,CEO
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Name | TIFFANY DAYE-LEE
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Credential | PMHNP-BC
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Telephone | 215-927-6417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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