Provider Demographics
NPI:1811190002
Name:SCHUBERT, LISA JANE (OT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:JANE
Last Name:SCHUBERT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 CARTER STREET
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402
Mailing Address - Country:US
Mailing Address - Phone:423-490-7710
Mailing Address - Fax:423-490-7750
Practice Address - Street 1:1101 CARTER STREET
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402
Practice Address - Country:US
Practice Address - Phone:423-490-7710
Practice Address - Fax:423-490-7750
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT0000002284225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist