Provider Demographics
NPI:1396188199
Name:PIRRAGLIA, LISA MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:PIRRAGLIA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:TROTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:115 E HARMONY RD STE 160
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3280
Mailing Address - Country:US
Mailing Address - Phone:970-221-1201
Mailing Address - Fax:800-675-0273
Practice Address - Street 1:115 E HARMONY RD STE 160
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3280
Practice Address - Country:US
Practice Address - Phone:970-221-1201
Practice Address - Fax:800-675-0273
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0002955225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist