Individual
MRS. LISA LYNN O'SHASKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1351 WISCONSIN RIVER DR, PORT EDWARDS, WI 54469-1041
(715) 885-8300
Mailing address
1351 WISCONSIN RIVER DR, PORT EDWARDS, WI 54469-1041
(715) 885-8300
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
778-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40751900
—
WI
Enumeration date
05/20/2008
Last updated
05/20/2008
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