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NPI Code Detail

MEDICARE: SHATIQUA C LYONS LSW

MEDICARE: SHATIQUA C LYONS LSW
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
1104100000XSocial WorkerS.2511951OH

General Provider Information

NPI Number : 1881489771
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHATIQUA C LYONS LSW
Provider Business Mailing Address
First Line : 14 HIGHLAND AVE
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-2321
Country : US
Telephone Number : 330-307-3962
Fax Number :
Provider Business Practice Location Address
First Line : 14 HIGHLAND AVE
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-2321
Country : US
Telephone Number : 330-307-3962
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2025
Last Update Date : 04/11/2025

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Directions to “ SHATIQUA C LYONS LSW” Practice Location

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