Individual
LISA M HERBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4100 S RIVER RD, EAST CHINA, MI 48054-2909
(810) 329-5385
Mailing address
4100 S RIVER ROAD, EAST CHINA, MI 48054-2914
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
5201002914
MI
2081P0010X
Pediatric Rehabilitation Medicine Physician
5201002914
MI
225X00000X
Occupational Therapist
52010022914
MI
225XP0200X
Pediatric Occupational Therapist
Primary
5201002914
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619941333
—
MI
Enumeration date
01/31/2019
Last updated
01/31/2019
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