Individual
JOHN A LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2701 12TH AVE S, FARGO, ND 58103-8753
(701) 451-4900
(651) 925-0057
Mailing address
1201 25TH ST S, PO BOX 9859, FARGO, ND 58103-2311
(701) 451-4900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4055
ND
Other
Enumeration date
12/28/2007
Last updated
02/17/2020
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