Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 056.006880 | IL |
Y | 225XG0600X | Occupational Therapist - Gerontology | OT21093 | FL |
NPI | 1043637887 |
---|---|
Provider Name | Mrs. Lisa Cone |
First Address | Spanish Fort, AL 36527-5853 |
Second Address | Pensacola, FL 32504-8511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2014 |
Last Update Date | 25/03/2021 |