Provider Demographics
NPI:1043050255
Name:LYONS, SUSAN THERESA (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:THERESA
Last Name:LYONS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3181 KINROSS CIR
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4043
Mailing Address - Country:US
Mailing Address - Phone:571-331-2855
Mailing Address - Fax:
Practice Address - Street 1:3181 KINROSS CIR
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:VA
Practice Address - Zip Code:20171-4043
Practice Address - Country:US
Practice Address - Phone:571-331-2855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002837235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist