Individual
BRIANNE AILEEN LYDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
169 ELM ST, WALTHAM, MA 02453-5356
(781) 647-0542
Mailing address
2 PARKER RD, SHIRLEY, MA 01464-2122
(978) 609-7701
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
119508
MA
Other
Enumeration date
09/29/2018
Last updated
09/29/2018
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