Individual
LISA L OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 S DIVISION AVE, SANDPOINT, ID 83864-1759
(208) 265-4514
Mailing address
421 S BOYER AVE, SANDPOINT, ID 83864-1101
(208) 699-9635
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-792
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
ID
Enumeration date
11/03/2016
Last updated
11/03/2016
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