Provider Demographics
NPI:1801040902
Name:WORCESTER, LISA HELEN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:HELEN
Last Name:WORCESTER
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 1:2604 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-5011
Mailing Address - Country:US
Mailing Address - Phone:540-657-1423
Mailing Address - Fax:540-657-4124
Practice Address - Street 1:2604 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-5011
Practice Address - Country:US
Practice Address - Phone:540-657-1423
Practice Address - Fax:540-657-4124
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003250225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics