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General NPI Number Information
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NPI Number | 1598831711
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Entity Type | Individual
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Provider Name | LISA ANN BRANSCUM OTR
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1499 6TH ST NW
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City | WINTER HAVEN
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State | FL
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Zip | 33881-2365
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Country | US
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Telephone | 863-293-7778
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Fax | 863-299-3836
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Provider Business Mailing Address
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Address Line | 1499 6TH ST NW
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City | WINTER HAVEN
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State | FL
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Zip | 33881-2365
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Country | US
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Telephone | 863-293-7778
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Fax | 863-299-3836
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31002976A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT26593
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License Number State | FL
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