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NPI Code Detail

MEDICARE: MRS. LISA MARIE WALTERS OTR/L, CHT

MEDICARE: MRS. LISA MARIE WALTERS OTR/L, CHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XH1200XHand Occupational Therapist260440KY
2225X00000XOccupational Therapist260440KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477542009
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA MARIE WALTERS OTR/L, CHT
Provider Business Mailing Address
First Line : 1012 DOE MEADOW CT
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-2064
Country : US
Telephone Number : 571-217-0137
Fax Number :
Provider Business Practice Location Address
First Line : 2195 HARRODSBURG RD FL 2
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-3516
Country : US
Telephone Number : 595-621-9808
Fax Number : 859-257-0573
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 02/16/2022

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