| Doctor Name: | MRS. NICOL LYNN LYON |
| NPI Number: | 1083832653 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CSC-AD |
| License Number: | 007343 |
| Business Practice Address: | 14701 National Hwy Sw Suites 5 & 6 Lavale, MD - 215026573 |
| Business Phone Number: | 3016870940 |
| Business Fax Number: | 3016870948 |
| Mailing Address: | 668 Walnut Dr, FROSTBURG |
| State: | MD |
| Postal Code: | 215326045 |
| Phone Number: | 3016870940 |
| Fax Number: | 3016870948 |
| NPI Enumeration Date: | 04/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 007343 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |