Individual
LISE KETTERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA. NHA
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2214
CA
224Z00000X
Occupational Therapy Assistant
OTA.0000024
CO
225X00000X
Occupational Therapist
Primary
—
—
376G00000X
Nursing Home Administrator
NHA.0002857
CO
Other
Enumeration date
11/15/2012
Last updated
11/27/2023
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