Provider Demographics
NPI:1992691851
Name:LYERLY, CRYSTALYN BROOKE
Entity type:Individual
Prefix:
First Name:CRYSTALYN
Middle Name:BROOKE
Last Name:LYERLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 ENCHANTED OAKS DR
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:SC
Mailing Address - Zip Code:29384-3625
Mailing Address - Country:US
Mailing Address - Phone:864-684-3003
Mailing Address - Fax:
Practice Address - Street 1:1027 EDGEFIELD ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-3205
Practice Address - Country:US
Practice Address - Phone:864-676-0028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist