Individual
LISA ANN SPONSELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2934 MILLER DR, PLYMOUTH, IN 46563-8083
(574) 941-2200
(574) 941-2206
Mailing address
2934 MILLER DR, PLYMOUTH, IN 46563-8083
(574) 941-2200
(574) 941-2206
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31000303A
IN
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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