Individual
LISA STOUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1270 GOLF VIEW DR, MONDOVI, WI 54755-5002
(715) 579-3052
Mailing address
1270 GOLF VIEW DR, MONDOVI, WI 54755-5002
(715) 579-3052
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.012338
IL
225X00000X
Occupational Therapist
Primary
20244
CA
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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