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General NPI Number Information
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NPI Number | 1679082457
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Entity Type | Individual
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Provider Name | MEGAN LEIGH LYONS PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 3120 MEMORIAL DR
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City | TWO RIVERS
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State | WI
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Zip | 54241-3229
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Country | US
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Telephone | 920-657-1780
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Fax |
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Provider Business Mailing Address
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Address Line | 6706 W ZANDER RD
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City | DENMARK
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State | WI
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Zip | 54208-9513
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Country | US
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Telephone | 517-227-0747
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3952-57
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License Number State | WI
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