Individual
LISA WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4702 NC HIGHWAY 48, ROANOKE RAPIDS, NC 27870-8505
(252) 717-3044
Mailing address
2700 THACKERY RD APT 31, GREENVILLE, NC 27858-8687
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8229
NC
Other
Enumeration date
03/17/2019
Last updated
03/17/2019
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