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Individual

CHEYENNE CIERRA LYONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
112 N 3RD STREET, LEESVILLE, LA 71446-7144
(337) 239-3334
(337) 239-3336
Mailing address
112 N 3RD ST, LEESVILLE, LA 71446-4014

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
710895055
LA
Enumeration date
11/18/2021
Last updated
11/18/2021
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