Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 5776 | MA |
NPI | 1134348568 |
---|---|
Provider Name | Mrs. Kara Lisa Lesiege |
First Address | Medway, MA 02053-2024 |
Second Address | Framingham, MA 01701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 01/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000447001 | MEDICARE PTAN (01) | MA |