Individual
CHEYANNA CHRISTINE LIERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
267 N. CANYON DRIVE, GOODING, ID 83330
(208) 934-8766
Mailing address
267 N. CANYON DRIVE, GOODING, ID 83330
(208) 934-8766
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1619
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT-1619
STATE LICENSURE
ID
Enumeration date
11/07/2018
Last updated
11/07/2018
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