Lisa Wood
Occupational Therapy Assistant in Villa Rica, GA. Individual provider (NPI-1).
NPI number1487984019
StatusActive
Last updated in NPPESOct 11, 2011
Details
- NPI
- 1487984019
- Entity type
- Individual (NPI-1)
- Name
- Lisa Wood
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 4, 2010
- Last updated
- Oct 11, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | OTA001291 | GA | Yes |
| 224Z00000X | Occupational Therapy Assistant | 32001740A | IN | |
| 224Z00000X | Occupational Therapy Assistant | A4278 | KY |
Practice location
1207 Woods WalkVilla Rica, GA 30180
Phone 812-431-1098
Mailing address
1207 Woods WalkVilla Rica, GA 30180-6912
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