Individual
TARA LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1157 HIGHLAND AVE, CHESHIRE, CT 06410-1600
(203) 271-2056
(203) 271-9817
Mailing address
PO BOX 851, MARION, CT 06444-0851
(860) 621-9771
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
001391
CT
Other
Enumeration date
07/04/2007
Last updated
07/08/2007
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