Individual
GRETA CAROLINE LYDERS
Active
Individual
GRETA CAROLINE LYDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2122
OR
103TC0700X
Clinical Psychologist
PSY17288
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500626679
—
OR
05
—
6HN3SQ4DL
—
OR
Enumeration date
01/08/2007
Last updated
04/10/2018
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