Individual
LISE GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
109 RHODE ISLAND RD, SHRIVER, LAKEVILLE, MA 02347-1370
(508) 923-6032
(508) 923-6361
Mailing address
155 GEORGE WASHINGTON BLVD, UNIT 410, HULL, MA 02045-3000
(508) 923-6032
(508) 923-6361
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6044
MA
Other
Enumeration date
12/15/2005
Last updated
07/08/2007
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