Lisa Jill Mick, OT
Specialist in Albuquerque, NM. Individual provider (NPI-1).
NPI number1821189473
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1821189473
- Entity type
- Individual (NPI-1)
- Name
- Lisa Jill Mick
- Credential
- OT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 27, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 1421 | NM | Yes |
Practice location
5200 Copper Ave NeAlbuquerque, NM 87108-1473
Phone 505-255-5099
Mailing address
5200 Copper Ave NeAlbuquerque, NM 87108-1473
Phone 505-255-5099
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