Provider Demographics
NPI:1104093400
Name:MCPHEE, LISA MARIE (OTR)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:MCPHEE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56528 ASH RD
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46561-9661
Mailing Address - Country:US
Mailing Address - Phone:609-276-0793
Mailing Address - Fax:
Practice Address - Street 1:56528 ASH RD
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IN
Practice Address - Zip Code:46561-9661
Practice Address - Country:US
Practice Address - Phone:609-276-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004548A225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200892250AMedicaid