Provider Demographics
NPI:1841087103
Name:LYONS, DESIRAE CHRISTINE
Entity type:Individual
Prefix:
First Name:DESIRAE
Middle Name:CHRISTINE
Last Name:LYONS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 W BROOKHAVEN RD APT G13
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-1828
Mailing Address - Country:US
Mailing Address - Phone:484-340-7606
Mailing Address - Fax:
Practice Address - Street 1:532 W BROOKHAVEN RD APT G13
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:PA
Practice Address - Zip Code:19015-1828
Practice Address - Country:US
Practice Address - Phone:484-340-7606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program