Individual
LARA LYNETTE NIEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR, ATP
Contact information
Practice address
PO BOX 4140, STATELINE, NV 89449-4140
(432) 638-8797
(432) 687-4290
Mailing address
PO BOX 4140, STATELINE, NV 89449-4140
(432) 638-8797
(432) 687-4290
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
109138
TX
225X00000X
Occupational Therapist
Primary
OT-2579
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407058886
—
NV
05
—
1407058886
—
TX
Enumeration date
06/05/2007
Last updated
05/15/2024
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