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Individual
MS. LISA RENAE WARREN
Active
Individual
MS. LISA RENAE WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10419
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008E
BCBS
FL
Enumeration date
01/09/2007
Last updated
09/18/2007
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