Provider Demographics
NPI:1669926382
Name:LIENOU, THIERRY YAMSI
Entity type:Individual
Prefix:
First Name:THIERRY
Middle Name:YAMSI
Last Name:LIENOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6108 42ND AVE
Mailing Address - Street 2:APT C 301
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-1419
Mailing Address - Country:US
Mailing Address - Phone:202-714-6468
Mailing Address - Fax:
Practice Address - Street 1:6108 42ND AVE
Practice Address - Street 2:APT C 301
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-1419
Practice Address - Country:US
Practice Address - Phone:202-714-6468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07897225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist