| Doctor Name: | RICHARD LYELL |
| NPI Number: | 1144465162 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RASAC II |
| License Number: | |
| Business Practice Address: | 1109 Jones St Kennett, MO - 638573824 |
| Business Phone Number: | 5738886545 |
| Business Fax Number: | 5738882369 |
| Mailing Address: | Po Box 470, KENNETT |
| State: | MO |
| Postal Code: | 638570470 |
| Phone Number: | 5738886545 |
| Fax Number: | 5738882369 |
| NPI Enumeration Date: | 12/04/2008 |
| NPI Last Update Date: | 05/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |