Individual
LISA WIDMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6530 HAWKS CREEK CT, FORT WORTH, TX 76114-1163
(888) 332-9928
(817) 810-0240
Mailing address
317 WATER OAK, DENTON, TX 76209-6517
(469) 237-6264
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
119768
TX
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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