Individual
LISA MARIE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
245 NORTH ST, BRISTOL, VA 24201-3274
(276) 669-4711
Mailing address
PO BOX 153, COEBURN, VA 24230-0153
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001336
VA
Other
Enumeration date
04/17/2017
Last updated
04/17/2017
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