Provider Demographics
NPI:1972716934
Name:STOOPS, LISA MARIE (PTA & COTA)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:STOOPS
Suffix:
Gender:F
Credentials:PTA & COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:101 2ND AVE LAKEMONT
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-3937
Mailing Address - Country:US
Mailing Address - Phone:814-949-9086
Mailing Address - Fax:866-360-5916
Practice Address - Street 1:101 2ND AVE LAKEMONT
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-3937
Practice Address - Country:US
Practice Address - Phone:814-949-9086
Practice Address - Fax:866-360-5916
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006295224Z00000X
PATE007519225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant