Provider Demographics
NPI:1437356227
Name:LYON, ELIZABETH BLANCHE (COTA)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:BLANCHE
Last Name:LYON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
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Mailing Address - Street 1:3510 SPINDLE ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-3147
Mailing Address - Country:US
Mailing Address - Phone:330-454-6026
Mailing Address - Fax:
Practice Address - Street 1:2714 13TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-3121
Practice Address - Country:US
Practice Address - Phone:330-456-2842
Practice Address - Fax:330-456-5343
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA02717224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant