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General NPI Number Information
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NPI Number | 1003275686
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Entity Type | Individual
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Provider Name | LISA GEORGE MS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 4400 JENIFER ST NW SUITE 280
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City | WASHINGTON
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State | DC
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Zip | 20015-2113
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Country | US
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Telephone | 202-244-8089
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Fax |
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Provider Business Mailing Address
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Address Line | 6504 TENDER MIST MEWS
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City | COLUMBIA
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State | MD
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Zip | 21044-6026
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Country | US
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Telephone | 410-207-1689
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT987
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 04483
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License Number State | MD
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