Lisa Rae Tebo, OTR/L
Individual provider Active NPI Occupational Therapist · Tupper Lake, NY
NPI 1992974802 · NPPES record last updated Feb 25, 2008
Key facts
- NPI
- 1992974802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 006114-1 (NY)
- Practice address
- 5 Cherry LN
Tupper Lake, NY 12986-1075 - Phone
- (518) 359-9495
- NPI assigned
- Feb 25, 2008
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 006114-1 | NY | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 006114-1 | NY | Yes |
Addresses
Primary practice location
5 Cherry LN
Tupper Lake, NY 12986-1075
Mailing address
5 Cherry LN
Tupper Lake, NY 12986-1075
Phone (518) 359-9495
Other names
- Ms. Lisa Rae Shellhammer
Other providers in Tupper Lake, NY
- Jessica Snyder
- State of New York
- State of New York
- State of New York
- State of New York
- Tupper Lake Center LLC
- Tupper Lake Central School District
- Tupper Lake Volunteer Ambulance & Emergency Squad Inc
- Walgreen Co
- Matthew S Warner
All providers in Tupper Lake, NY · Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.