Provider Demographics
NPI:1386956845
Name:OWEN, LISA (OT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:OWEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:NEWCOMBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:35 DAHL RD
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-4535
Mailing Address - Country:US
Mailing Address - Phone:603-470-4086
Mailing Address - Fax:
Practice Address - Street 1:17 RIVERSIDE ST
Practice Address - Street 2:STE 101
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1383
Practice Address - Country:US
Practice Address - Phone:603-883-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2052225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist