Provider Demographics
NPI:1023248689
Name:LYONS, ERICA LEE (MS, CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LEE
Last Name:LYONS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:FONK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2323 N 90TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1828
Mailing Address - Country:US
Mailing Address - Phone:920-242-6395
Mailing Address - Fax:
Practice Address - Street 1:17700 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2006
Practice Address - Country:US
Practice Address - Phone:262-781-3083
Practice Address - Fax:262-781-3080
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3185-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist