Provider Demographics
NPI:1952463945
Name:TIEMANN, KELLY LISBETHROLLINS (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:LISBETHROLLINS
Last Name:TIEMANN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:4746 HUMMINGBIRD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-4916
Mailing Address - Country:US
Mailing Address - Phone:281-235-4115
Mailing Address - Fax:
Practice Address - Street 1:8021 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-5200
Practice Address - Country:US
Practice Address - Phone:713-774-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110285225X00000X, 225XN1300X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics