Individual
MRS. LISA GERARD FAULISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
20 NEWMAN AVE., SUITE 1025, RUMFORD, RI 02916
(401) 610-0639
Mailing address
15 LOOP DRIVE, NORTH KINGSTON, RI 02852
(401) 610-0639
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
000116
RI
225XP0200X
Pediatric Occupational Therapist
Primary
MO2005013549
MO
Other
Enumeration date
02/16/2007
Last updated
08/09/2024
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