Provider Demographics
NPI:1952119026
Name:LYONS, REBECCA JANE (IBCLC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JANE
Last Name:LYONS
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3492 BLUE SPRUCE CT SW
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-5570
Mailing Address - Country:US
Mailing Address - Phone:404-281-3583
Mailing Address - Fax:
Practice Address - Street 1:3492 BLUE SPRUCE CT SW
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-5570
Practice Address - Country:US
Practice Address - Phone:404-281-3583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAL-24049174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN