Individual
LISA DEFEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
108 OVERLOOK DR, BLYTHEWOOD, SC 29016-9100
(803) 261-4965
Mailing address
108 OVERLOOK DR, BLYTHEWOOD, SC 29016-9100
(803) 261-4965
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1647
SC
Other
Enumeration date
12/30/2017
Last updated
12/30/2017
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