Individual
LISA A DELACERDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
180 HACKBERRY DR, BULLARD, TX 75757-9506
(903) 258-0197
Mailing address
180 HACKBERRY DR, BULLARD, TX 75757-9506
(903) 258-0197
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
Enumeration date
02/17/2010
Last updated
02/19/2024
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