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Individual

KARISSA LILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
497 TUCKER DR, MAYSVILLE, KY 41056-9111
(606) 759-4005
Mailing address
12695 KY 57, TOLLESBORO, KY 41189-8534
(606) 407-1000

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
279491
KY

Other

Enumeration date
08/15/2022
Last updated
08/15/2022
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