Individual
LISA DANVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
685 RIVER AVE, LAKEWOOD, NJ 08701-5288
(732) 367-3667
Mailing address
12 MARIAN CIR, CHALFONT, PA 18914-2700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC008468
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I5073211
CAQH
PA
Enumeration date
01/27/2021
Last updated
01/27/2021
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