Individual
AMY LYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LPC,RPT
Contact information
Practice address
904 RIVER RD, WIMBERLEY, TX 78676-5102
(512) 644-1778
Mailing address
904 RIVER RD, WIMBERLEY, TX 78676-5102
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
17460
TX
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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