Individual
LISA M. DEWEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
587 N DEER ISLE RD, DEER ISLE, ME 04627-3438
(207) 951-3925
Mailing address
38 MUSHRALL LN, ORLAND, ME 04472-4107
(207) 951-3925
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2776
ME
225X00000X
Occupational Therapist
878
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2776
ME BOARD OF OT
ME
05
—
7501065000
—
WV
01
—
878
WV BOARD OF OT
WV
Enumeration date
01/09/2006
Last updated
04/10/2017
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