Provider Demographics
NPI:1184818064
Name:RICE, LISA O
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:O
Last Name:RICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 EDGEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27863-9296
Mailing Address - Country:US
Mailing Address - Phone:919-920-4206
Mailing Address - Fax:919-242-8697
Practice Address - Street 1:103 EDGEBROOK DR
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:NC
Practice Address - Zip Code:27863-9296
Practice Address - Country:US
Practice Address - Phone:919-920-4206
Practice Address - Fax:919-242-8697
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist