Individual
MRS. LISA MARIE CONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R., C.H.T.
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
970694
—
225XH1200X
Hand Occupational Therapist
Primary
9511000148
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102255327
OWCP FACILITY PROVIDER ID
—
Enumeration date
08/05/2006
Last updated
08/08/2013
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