Lyeth, Genevieve Autumn-Rose Judith

Lyeth, Genevieve Autumn-Rose Judith is an individual health care provider with primary practice located at 400 Saint Louis St Ste 1 , Edwardsville IL 62025-1979. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Lyeth, Genevieve Autumn-Rose Judith can be contacted via phone (844) 244-1818.

Contact Information

Primary practice address
400 Saint Louis St Ste 1 Edwardsville IL 62025-1979
Phone: (844) 244-1818
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1124602354
LBN Legal business name Lyeth, Genevieve Autumn-Rose Judith
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2021
Last updated May 12th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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