MEDICARE: ERICA LYMAN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	11375	MA

General Provider Information

NPI Number	:	1316342157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LYMAN OTR/L

Provider Business Mailing Address
First Line	:	63 COLUMBIA DR.
Second Line	:
City	:	FEEDING HILLS
State	:	MA
Zip	:	01030-0000
Country	:	US
Telephone Number	:	413-297-7860
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 COLUMBIA DR.
Second Line	:
City	:	FEEDING HILLS
State	:	MA
Zip	:	01030-0000
Country	:	US
Telephone Number	:	413-297-7860
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2014
Last Update Date	:	10/22/2014

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