Lyles, Ed Davis

Lyles, Ed Davis is an individual health care provider with primary practice located at 350 City View Dr #302, Evanston WY 82930-5327. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Lyles, Ed Davis can be contacted via phone (307) 789-7915.

Contact Information

Primary practice address
350 City View Dr #302 Evanston WY 82930-5327
Phone: (307) 789-7915
Fax: (307) 789-6009
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-408 Wyoming

Profile Details

NPI number 1265655427
LBN Legal business name Lyles, Ed Davis
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2007
Last updated Jul 9th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1265655427 NPPES
Wyoming Other 313191 BCBS OF WYOMING

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