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Individual

LISA M. DREISKE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
601 MAIN AVE, LEMMON, SD 57638-1834
(605) 374-5844
(605) 374-9524
Mailing address
601 MAIN AVE, LEMMON, SD 57638-1834
(605) 374-5844
(605) 374-9524

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0543
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4996665
WELLMARK BCBS
SD
01
52624
ND MEDICAID
ND
05
5833250
SD
01
9192188
DAKOTACARE
SD
Enumeration date
02/09/2006
Last updated
07/08/2007
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