Provider Demographics
NPI:1710014030
Name:LILLEY, BRYNDA KAY (BSW SOCIAL WORKER)
Entity Type:Individual
Prefix:
First Name:BRYNDA
Middle Name:KAY
Last Name:LILLEY
Suffix:
Gender:F
Credentials:BSW SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORRILTON
Mailing Address - State:AR
Mailing Address - Zip Code:72110
Mailing Address - Country:US
Mailing Address - Phone:479-967-5570
Mailing Address - Fax:479-890-5364
Practice Address - Street 1:8 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:MORRILTON
Practice Address - State:AR
Practice Address - Zip Code:72110
Practice Address - Country:US
Practice Address - Phone:479-967-5570
Practice Address - Fax:479-890-5364
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker