Individual
KATHRYN MARY LYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
179 E BURR BLVD STE L, KEARNEYSVILLE, WV 25430-4964
(304) 268-5330
Mailing address
632 RUDDER RD, SHEPHERDSTOWN, WV 25443-4239
(843) 957-1034
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SW112116078
WV
1041C0700X
Clinical Social Worker
Primary
BP00946159
WV
Other
Enumeration date
02/03/2022
Last updated
10/03/2022
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