Individual
MRS. LISA KAY LUCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
789 JUSTIN RD, ROCKWALL, TX 75087-4840
(972) 771-5731
(972) 771-5786
Mailing address
1423 HOLLYWOOD AVE, DALLAS, TX 75208-7728
(214) 331-4460
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100136
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T3240
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/25/2006
Last updated
07/08/2007
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