Individual
LISA RENEA ROUNDTREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3515 S PARK AVE, DENISON, TX 75020-7342
(903) 327-8537
Mailing address
360 WILLIS RD, MEAD, OK 73449-5265
(903) 271-8281
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209322
TX
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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