Provider Demographics
NPI:1083624274
Name:GRIFFITH, LISA A (OTR)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:GRIFFITH
Suffix:
Gender:
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 SNEAD RD
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-6541
Mailing Address - Country:US
Mailing Address - Phone:704-953-2079
Mailing Address - Fax:704-953-2079
Practice Address - Street 1:4614 WILGROVE MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-3500
Practice Address - Country:US
Practice Address - Phone:704-953-2079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1064225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist