Individual
LISA FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3505 OLD JACKSONVILLE RD, TYLER, TX 75701-8510
(903) 581-4778
Mailing address
3505 OLD JACKSONVILLE RD, TYLER, TX 75701-8510
(903) 581-4778
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210301
TX
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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