=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730526187
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LISA FRANCES BROWN OTR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2013
-----------------------------------------------------
Last Update Date | 05/24/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 95 W MAIN ST
-----------------------------------------------------
City | CHESTER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07930-2487
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-879-7067
-----------------------------------------------------
Fax | 908-879-4117
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 95 W MAIN ST
-----------------------------------------------------
City | CHESTER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07930-2487
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-879-7067
-----------------------------------------------------
Fax | 908-879-4117
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------