Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1316403264 |
---|---|
Provider Name | Mrs. Ashley Elizabeth Lyons |
First Address | Atlanta, GA 30329-2206 |
Second Address | Atlanta, GA 30329-2206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2019 |
Last Update Date | 15/02/2019 |