Individual
MS. LISA CONNER GERRITSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5937 COVE RD, ROANOKE, VA 24019-2403
(540) 562-3900
Mailing address
3932 BLUEBIRD LN, SALEM, VA 24153-8060
(540) 598-8501
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000529
VA
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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