Camille Lyon
Occupational Therapist, Gerontology in Saint Louis, MO. Individual provider (NPI-1).
NPI number1164084455
StatusActive
Last updated in NPPESJun 12, 2026
Details
- NPI
- 1164084455
- Entity type
- Individual (NPI-1)
- Name
- Camille Lyon
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2019
- Certification date
- Jun 12, 2026
- Last updated
- Jun 12, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225XG0600X | Occupational Therapist, Gerontology | 2019017425 | MO | Yes |
Other names
- Camille Fagan (Former Name)
Practice location
11960 Westline Industrial Dr Ste 201Saint Louis, MO 63146-3209
Phone 866-433-9555
Mailing address
27130 Hunt DrWright City, MO 63390-4419
Phone 314-446-9041
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