Individual
CAITLIN M LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1420 N HIGHWAY 33 STE 106, DRIGGS, ID 83422-5313
(208) 240-2820
(208) 656-5647
Mailing address
3808 WOOD RD, VICTOR, ID 83455-5352
(208) 240-2820
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-1526
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IDTPID012938
—
ID
Enumeration date
09/28/2018
Last updated
11/10/2023
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