Provider Demographics
NPI:1285120097
Name:LYDAY, KIMBERLY (MA, MT-BC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:LYDAY
Suffix:
Gender:F
Credentials:MA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 NORWOOD HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2352
Mailing Address - Country:US
Mailing Address - Phone:585-755-0689
Mailing Address - Fax:
Practice Address - Street 1:445 ASHTON DR
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1982
Practice Address - Country:US
Practice Address - Phone:585-755-0689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-04
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist