Individual
LISE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
315 E CLINTON ST, HOBBS, NM 88240-8238
(575) 393-0755
Mailing address
315 E CLINTON ST, HOBBS, NM 88240-8238
(575) 393-0755
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA3469
NM
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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