Individual
MRS. LISA PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
12021 LIVINGSTON RD, FORT WASHINGTON, MD 20744-4210
(301) 292-0300
Mailing address
2465 REVERDY FARM RD, INDIAN HEAD, MD 20640-3693
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02520
MD
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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