Individual
LISA MARIE CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
130 JOHNSON RD, OAK RIDGE, TN 37830-3650
(865) 661-5480
Mailing address
130 JOHNSON RD, OAK RIDGE, TN 37830-3650
(865) 661-5480
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
1921
TN
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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