Individual
LISA DAVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
1513 WESTBURY DR, SHREVEPORT, LA 71105-5031
(318) 469-1955
Mailing address
1513 WESTBURY DR, SHREVEPORT, LA 71105-5031
(318) 469-1955
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z10765
LA
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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