Provider Demographics
NPI:1447774005
Name:WINDSOR, LISA LYNN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:LYNN
Last Name:WINDSOR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 SOUTHLAND CIR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-7821
Mailing Address - Country:US
Mailing Address - Phone:501-326-4397
Mailing Address - Fax:
Practice Address - Street 1:300 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-4003
Practice Address - Country:US
Practice Address - Phone:501-622-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR596225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty