Individual
JOAN LYALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC/SLP
Contact information
Practice address
113 ASHLAND AVENUE, BALA CYNWYD, PA 19004
(516) 729-9406
Mailing address
113 ASHLAND AVENUE, BALA CYNWYD, PA 19004
(516) 729-9406
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS0069
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41YS0069
NJ LICENSE NO: 41YS00696400
NJ
Enumeration date
08/18/2015
Last updated
08/18/2015
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