Provider Demographics
NPI:1033422399
Name:BAUM, LISA A (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:BAUM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:AUERBACH
Other - Last Name:BAUM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:7812 OAK LANE RD
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-1015
Mailing Address - Country:US
Mailing Address - Phone:215-782-2242
Mailing Address - Fax:215-782-3203
Practice Address - Street 1:7812 OAK LANE RD
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1015
Practice Address - Country:US
Practice Address - Phone:215-782-2242
Practice Address - Fax:215-782-3203
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC-000902L225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics