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Individual

MR. MATTHEW LYON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCDC

Contact information

Practice address
1510 S VINE AVE, TYLER, TX 75701-2826
(903) 526-4055
Mailing address
2419 VZ COUNTY ROAD 2318, CANTON, TX 75103-4873

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14377
TX

Other

Enumeration date
12/02/2019
Last updated
12/02/2019
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