Healthcare Provider Details

I. General information

NPI: 1750272266
Provider Name (Legal Business Name): LISA TAYLOR OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2025
Last Update Date: 07/12/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8226 MEADOWBRIDGE RD
MECHANICSVILLE VA
23116-2331
US

IV. Provider business mailing address

537 RAMSEY RD
FISHERSVILLE VA
22939-2314
US

V. Phone/Fax

Practice location:
  • Phone: 804-764-1000
  • Fax:
Mailing address:
  • Phone: 540-290-5129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011019
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: