MEDICARE: JESSICA LYMAN OTR

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	117862	TX

General Provider Information

NPI Number	:	1457896151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LYMAN OTR

Provider Business Mailing Address
First Line	:	10 DEAVER DR
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-1304
Country	:	US
Telephone Number	:	724-234-5568
Fax Number	:

Provider Business Practice Location Address
First Line	:	340 N SAM HOUSTON PKWY E STE 199
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3325
Country	:	US
Telephone Number	:	281-822-0808
Fax Number	:

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

Provider Enumeration Date	:	01/04/2017
Last Update Date	:	10/03/2023

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