Provider Demographics
NPI:1780984468
Name:LYONS, JOANN WELCH
Entity type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:WELCH
Last Name:LYONS
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 1:18 LACOSTA DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-1255
Mailing Address - Country:US
Mailing Address - Phone:518-877-6663
Mailing Address - Fax:
Practice Address - Street 1:1 MADELON HICKEY WAY
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-4104
Practice Address - Country:US
Practice Address - Phone:518-233-1900
Practice Address - Fax:518-237-1964
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist