Provider Demographics
NPI:1801347497
Name:LYONS, SHARONE MARTHA
Entity type:Individual
Prefix:
First Name:SHARONE
Middle Name:MARTHA
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 1:4813 HASSAN CIR
Mailing Address - Street 2:APT 3
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45432-1342
Mailing Address - Country:US
Mailing Address - Phone:414-499-6830
Mailing Address - Fax:
Practice Address - Street 1:4813 HASSAN CIR
Practice Address - Street 2:APT 3
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45432-1342
Practice Address - Country:US
Practice Address - Phone:414-499-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2255A2300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer