Individual
AISHA LYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
64 DANBURY RD, WILTON, CT 06897-4429
(800) 278-0332
Mailing address
180 JACKSON ST NE APT 2318, ATLANTA, GA 30312-1370
(678) 516-0639
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005489
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT005489
GEORGIA BOARD OF OCCUPATIONAL THERAPY
GA
Enumeration date
08/07/2012
Last updated
02/16/2022
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