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Individual

MRS. LISA MARIE WALTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L, CHT

Contact information

Practice address
2195 HARRODSBURG RD FL 2, LEXINGTON, KY 40504-3516
(595) 621-9808
(859) 257-0573
Mailing address
1012 DOE MEADOW CT, LEXINGTON, KY 40509-2064
(571) 217-0137

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
260440
KY
225XH1200X
Hand Occupational Therapist
260440
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100632600
KY
Enumeration date
10/17/2005
Last updated
02/16/2022
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