Individual provider · NPI-1
Lisa Pelo, ATP, OTR
Technician, Other · Addison, TX
NPI number1952700544
StatusActive
Last updated in NPPESAug 19, 2014
Details
- NPI
- 1952700544
- Entity type
- Individual (NPI-1)
- Name
- Lisa Pelo
- Credential
- ATP, OTR
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 19, 2014
- Last updated
- Aug 19, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | 84320 | TX | Yes |
| 225X00000X | Occupational Therapist | 106463 | TX |
Practice location
4009 Lindbergh DrAddison, TX 75001-4343
Phone 972-428-3739
Mailing address
5309 Kara LnParker, TX 75002-6309
Phone 214-886-0522 · Fax 972-418-7786
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