Provider Demographics
NPI:1104043470
Name:SANCHEZ, LISA MARIE (OTA/L)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:SANCHEZ
Suffix:
Gender:
Credentials:OTA/L
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:BULONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:1844 WILLOWHILL LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-3770
Mailing Address - Country:US
Mailing Address - Phone:419-410-4554
Mailing Address - Fax:
Practice Address - Street 1:1050 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1904
Practice Address - Country:US
Practice Address - Phone:419-567-7281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2543224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant