Provider Demographics
NPI:1477897379
Name:LYGA, CHERI
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:
Last Name:LYGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N1434 GROUSE RD
Mailing Address - Street 2:
Mailing Address - City:SARONA
Mailing Address - State:WI
Mailing Address - Zip Code:54870-9061
Mailing Address - Country:US
Mailing Address - Phone:715-469-3443
Mailing Address - Fax:
Practice Address - Street 1:N1434 GROUSE RD
Practice Address - Street 2:
Practice Address - City:SARONA
Practice Address - State:WI
Practice Address - Zip Code:54870-9061
Practice Address - Country:US
Practice Address - Phone:715-469-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4960-27224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant