Provider Demographics
NPI:1497945976
Name:VOSE, LISA ANN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:VOSE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 274
Mailing Address - Street 2:168 RAYS WAY
Mailing Address - City:HARTFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05047-0274
Mailing Address - Country:US
Mailing Address - Phone:802-296-3134
Mailing Address - Fax:802-296-3134
Practice Address - Street 1:24 OLD ETNA RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1937
Practice Address - Country:US
Practice Address - Phone:603-442-4207
Practice Address - Fax:603-442-4250
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0635225X00000X
VT072-0000232225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist