Provider Demographics
NPI:1336356724
Name:LYONS, AMY L (MOTR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:LYONS
Suffix:
Gender:F
Credentials:MOTR
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LOCKHART
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MOTR
Mailing Address - Street 1:59 HARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1207
Mailing Address - Country:US
Mailing Address - Phone:860-537-2339
Mailing Address - Fax:
Practice Address - Street 1:59 HARRINGTON CT
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1207
Practice Address - Country:US
Practice Address - Phone:860-537-2339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002083225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist