Provider Demographics
NPI:1619241791
Name:SETSER, LISA DENISE (COTA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:DENISE
Last Name:SETSER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 S STATE HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-7808
Mailing Address - Country:US
Mailing Address - Phone:812-592-4975
Mailing Address - Fax:
Practice Address - Street 1:2260 S STATE HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-7808
Practice Address - Country:US
Practice Address - Phone:812-592-4975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001120A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant