Individual
MRS. LISA RENEE RICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2616 E LAWRENCE AVE, SPRINGFIELD, IL 62703-2023
(217) 220-2542
Mailing address
2616 E. LAWRENCE AVENUE, SPRINGFIELD, IL 62703-2023
(217) 220-2542
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057-001818
IL
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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