Individual
JESSICA LYKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
123 PIKE ST, PORT JERVIS, NY 12771-1824
(845) 856-7576
(845) 383-8010
Mailing address
123 PIKE ST, PORT JERVIS, NY 12771-1824
(845) 856-7576
(845) 383-8010
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
108127-01
NY
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007592970029
—
PA
Enumeration date
08/28/2014
Last updated
06/20/2022
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