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Individual
MRS. LYDIA ELYSE SHIVELY
Active
Individual
MRS. LYDIA ELYSE SHIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATR-P, LCMHCA
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A18504
NC
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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