Lisa Dias

Individual provider Active NPI Occupational Therapy Assistant · Kennebunk, ME

NPI 1124426150 · NPPES record last updated Oct 6, 2020

Key facts

NPI
1124426150
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
0842 (NH)
Practice address
3 Brazier LN
Kennebunk, ME 04043-7095
Phone
(774) 991-1159
NPI assigned
Dec 8, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0842NHMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X
Occupational Therapy Assistant 224Z00000X 0842 NH Yes

Addresses

Primary practice location

3 Brazier LN
Kennebunk, ME 04043-7095

Mailing address

358 Hare Rd
Milton, NH 03851-4716
Phone (774) 991-1159

Other practice location 1

151 Winthrop St
Rehoboth, MA 02769-2600
Phone (774) 991-1159

Other providers in Kennebunk, ME

All providers in Kennebunk, ME · Occupational Therapy Assistant in Maine

Sources for this page

Verify at the official NPI Registry.