Provider Demographics
NPI:1255063087
Name:LYERLY, CAMANTHA-REA
Entity type:Individual
Prefix:
First Name:CAMANTHA-REA
Middle Name:
Last Name:LYERLY
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 1:165 MAHALEY AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2448
Mailing Address - Country:US
Mailing Address - Phone:704-636-5522
Mailing Address - Fax:
Practice Address - Street 1:165 MAHALEY AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2448
Practice Address - Country:US
Practice Address - Phone:704-636-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional