Individual
LISA M HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
83 PEPPERDINE DR, PALM COAST, FL 32164-7498
(386) 793-3159
Mailing address
PO BOX 353842, PALM COAST, FL 32135-3842
(386) 793-3159
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
214087
TX
224Z00000X
Occupational Therapy Assistant
4394
AL
224Z00000X
Occupational Therapy Assistant
46TA09186500
NJ
224Z00000X
Occupational Therapy Assistant
OTA046825
AZ
224Z00000X
Occupational Therapy Assistant
Primary
OTA15358
FL
224Z00000X
Occupational Therapy Assistant
OTA3726
MS
224Z00000X
Occupational Therapy Assistant
OTA4227
NM
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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