Individual
LISA LYNN FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1240 ARBOR RD, WINSTON SALEM, NC 27104-1106
(336) 724-7921
Mailing address
1105 WELLESLEY PLACE DR, LEWISVILLE, NC 27023-8322
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3177
NC
Other
Enumeration date
06/28/2011
Last updated
06/28/2011
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