Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 3771 | SC |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 3771 | SC |
NPI | 1811387467 |
---|---|
Provider Name | Lisa Ann Dio |
First Address | Greer, SC 29650-2938 |
Second Address | Greer, SC 29650-2938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2015 |
Last Update Date | 03/02/2015 |