Provider Demographics
NPI:1679855936
Name:SESSION, LYDIA
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:SESSION
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 1:1627 S. HARGRAVE
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220
Mailing Address - Country:US
Mailing Address - Phone:951-922-7612
Mailing Address - Fax:951-922-7730
Practice Address - Street 1:1627 S. HARGRAVE
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220
Practice Address - Country:US
Practice Address - Phone:951-922-7612
Practice Address - Fax:951-922-7730
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2016-05-10
Deactivation Date:2013-06-18
Deactivation Code:
Reactivation Date:2016-05-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist