Provider Demographics
NPI:1386005080
Name:LYON, CARA
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:LYON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 E 400 S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-2838
Mailing Address - Country:US
Mailing Address - Phone:801-674-5352
Mailing Address - Fax:801-931-2607
Practice Address - Street 1:243 E 400 S
Practice Address - Street 2:SUITE 300
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-2838
Practice Address - Country:US
Practice Address - Phone:801-674-5352
Practice Address - Fax:801-931-2607
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst