Individual
MRS. LISA JANE EATON
Active
Individual
MRS. LISA JANE EATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L CAP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAP-190
WY
171M00000X
Case Manager/Care Coordinator
—
—
225X00000X
Occupational Therapist
Primary
686
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145664400
—
WY
05
—
1770688871
—
WY
Enumeration date
08/20/2007
Last updated
10/25/2021
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