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General NPI Number Information
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NPI Number | 1831368844
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Entity Type | Individual
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Provider Name | LISA MIZELL SLOAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/23/2008
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Last Update Date | 02/23/2008
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Provider Practice Location Address
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Address Line | 906 W 15TH ST
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City | WASHINGTON
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State | NC
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Zip | 27889-3533
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Country | US
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Telephone | 252-946-7145
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 BAILEY RD
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City | WILLIAMSTON
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State | NC
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Zip | 27892-8629
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Country | US
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Telephone | 252-792-4236
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0760
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License Number State | NC
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