Individual
MICHELLE MALLISSA LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
14775 W YORKSHIRE DR, SURPRISE, AZ 85374-7224
(623) 377-9698
Mailing address
11846 W JESSIE LN, SUN CITY, AZ 85373-5433
(336) 588-5565
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6231
NC
Other
Enumeration date
05/29/2007
Last updated
08/13/2013
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