Provider Demographics
NPI:1619275369
Name:BYERS, KRISTI LYNNE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LYNNE
Last Name:BYERS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3734
Mailing Address - Country:US
Mailing Address - Phone:540-589-5281
Mailing Address - Fax:
Practice Address - Street 1:3355 VIEW AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3734
Practice Address - Country:US
Practice Address - Phone:540-589-5281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-04
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01310002211224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant