Provider Demographics
NPI:1932701448
Name:KARDOS, LISA C (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:C
Last Name:KARDOS
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:C
Other - Last Name:KARDOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:76 PARKER MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825-6201
Mailing Address - Country:US
Mailing Address - Phone:978-290-2494
Mailing Address - Fax:
Practice Address - Street 1:76 PARKER MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NH
Practice Address - Zip Code:03825-6201
Practice Address - Country:US
Practice Address - Phone:978-290-2494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2748225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health