Provider Demographics
NPI:1174014542
Name:LYLE, KATHERINE E (MT-BC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:LYLE
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 N CROSS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7731
Mailing Address - Country:US
Mailing Address - Phone:770-862-0596
Mailing Address - Fax:
Practice Address - Street 1:1003 SR 662 W
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630
Practice Address - Country:US
Practice Address - Phone:812-490-9401
Practice Address - Fax:888-715-3298
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist