Provider Demographics
NPI:1952449274
Name:LYON, ELIZABETH L (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:L
Last Name:LYON
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 FINCASTLE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-4966
Mailing Address - Country:US
Mailing Address - Phone:919-707-5636
Mailing Address - Fax:919-870-4882
Practice Address - Street 1:5601 SIX FORKS RD
Practice Address - Street 2:SECOND BLDG, THIRD FLOOR
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3811
Practice Address - Country:US
Practice Address - Phone:919-707-5636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS