Provider Demographics
NPI:1356420848
Name:LYON, MELISSA BYERS (MA/CCC-A)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:BYERS
Last Name:LYON
Suffix:
Gender:F
Credentials:MA/CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 N WILSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-8609
Mailing Address - Country:US
Mailing Address - Phone:765-662-1702
Mailing Address - Fax:
Practice Address - Street 1:711 N RIVER DR STE B
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2673
Practice Address - Country:US
Practice Address - Phone:765-651-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001223A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist