Provider Demographics
NPI:1104903921
Name:GARRAWAY, LYDIA KRAHL (LPC)
Entity type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:KRAHL
Last Name:GARRAWAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-1603
Mailing Address - Country:US
Mailing Address - Phone:334-271-8912
Mailing Address - Fax:334-356-8957
Practice Address - Street 1:3845 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-1603
Practice Address - Country:US
Practice Address - Phone:334-271-8912
Practice Address - Fax:334-356-8957
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL987101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health