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Individual

LISA M DUSSAULT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
600 HIGHLAND AVE # E3/211, REHABILITATION THERAPY-2424, MADISON, WI 53792-0001
(608) 263-8060
(608) 262-7679
Mailing address
302 MORNINGSIDE AVE, MADISON, WI 53716-1733
(608) 222-1848

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2309
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2309
OT
WI
Enumeration date
07/24/2006
Last updated
07/08/2007
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