Individual
MRS. LISA MARIE OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
371 BROADWAY, KINGSTON, NY 12401-5151
(845) 334-2870
Mailing address
371 BROADWAY, KINGSTON, NY 12401-5151
(845) 334-2870
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
019714
NY
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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