Healthcare Provider Details

I. General information

NPI: 1801164595
Provider Name (Legal Business Name): LISA M CLEE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA M SACCO OTR/L

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

693 LEESVILLE RD
LYNCHBURG VA
24502-2828
US

IV. Provider business mailing address

PO BOX 749391
ATLANTA GA
30374-9391
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-7600
  • Fax: 434-200-1294
Mailing address:
  • Phone: 434-200-7600
  • Fax: 434-200-1294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011309
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: