MEDICARE: EDITH SNYDER LYMAN LCSW

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	1041C0700X	Clinical Social Worker	LC10494	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LC10494	OTHER	ME	ME LICENSE

General Provider Information

NPI Number	:	1861445900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDITH SNYDER LYMAN LCSW

Provider Business Mailing Address
First Line	:	322 MAIN ST
Second Line	:
City	:	BAR HARBOR
State	:	ME
Zip	:	04609-1637
Country	:	US
Telephone Number	:	207-288-8604
Fax Number	:

Provider Business Practice Location Address
First Line	:	322 MAIN ST
Second Line	:
City	:	BAR HARBOR
State	:	ME
Zip	:	04609-1637
Country	:	US
Telephone Number	:	207-288-8604
Fax Number	:

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	02/08/2008

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