Provider Demographics
NPI:1609102375
Name:LYON, JAYME LE RAE (MA)
Entity Type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:LE RAE
Last Name:LYON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 GAYLE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3450
Mailing Address - Country:US
Mailing Address - Phone:210-359-1673
Mailing Address - Fax:
Practice Address - Street 1:19500 BULVERDE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-3701
Practice Address - Country:US
Practice Address - Phone:210-339-5284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional