Organization
BRAVE YOGA FOR ALL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M IRVINE MS,OTR/L (OCCUPATIONAL THERAPIST)
(508) 330-1141
Entity
Organization
Contact information
Practice address
299 CLARK ROAD EXT, FISKDALE, MA 01518-1036
(508) 330-1141
Mailing address
299 CLARK ROAD EXT, FISKDALE, MA 01518-1036
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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