MEDICARE: MRS. LISA JUDITH FRIEDMAN MSW OTRL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OTH-000577	AZ
2	225X00000X	Occupational Therapist	15010	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15010	OTHER	CA	OT LICENSE
2	0577	OTHER	AZ	OT LICENSE

General Provider Information

NPI Number	:	1447462098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA JUDITH FRIEDMAN MSW OTRL

Provider Business Mailing Address
First Line	:	10980 E SISKIN PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85748-7011
Country	:	US
Telephone Number	:	520-991-3699
Fax Number	:

Provider Business Practice Location Address
First Line	:	10980 E SISKIN PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85748-7011
Country	:	US
Telephone Number	:	520-991-3699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	06/09/2026

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