Individual
ALICIA LYNN LYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
290 ARROWHEAD LN, SOUTH SETAUKET, NY 11720-1349
(516) 426-1810
Mailing address
290 ARROWHEAD LN, SOUTH SETAUKET, NY 11720-1349
(516) 426-1810
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
—
—
235Z00000X
Speech-Language Pathologist
Primary
031717-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2021
Last updated
11/09/2022
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