Individual
LISA G ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
310 EAST BROADWAY, SUITE 100, JACKSON, WY 83001
(307) 200-9520
Mailing address
PO BOX 726, JACKSON, WY 83001-0726
(307) 200-9520
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-441
WY
Other
Enumeration date
12/06/2006
Last updated
12/08/2016
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