| Patricia Lyman, Ph.d., Plc | |
|
11989 W Indian Lake Dr Vicksburg MI 49097-9369 | |
| (262) 744-1342 | |
| Not Available |
| Full Name | Patricia Lyman, Ph.d., Plc |
|---|---|
| Speciality | Psychologist |
| Location | 11989 W Indian Lake Dr, Vicksburg, Michigan |
| Authorized Official Name and Position | Patricia Ann Lyman (PSYCHOLOGIST) |
| Authorized Official Contact | 2697441342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patricia Lyman, Ph.d., Plc 11989 W Indian Lake Dr Vicksburg MI 49097-9369 Ph: (269) 744-1342 | Patricia Lyman, Ph.d., Plc 11989 W Indian Lake Dr Vicksburg MI 49097-9369 Ph: (262) 744-1342 |
| NPI Number | 1326402769 |
|---|---|
| Provider Enumeration Date | 04/12/2016 |
| Last Update Date | 09/11/2024 |
| Certification Date | 09/11/2024 |
| Medicare PECOS PAC ID | 3971894361 |
|---|---|
| Medicare Enrollment ID | O20160628000611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326402769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301006637 (Michigan) | Primary |
| Provider Name | Patricia A Lyman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649245655 PECOS PAC ID: 6305999616 Enrollment ID: I20090804000758 |
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