Provider Demographics
NPI:1134153117
Name:DREAGER, LISA M (OTR/L, HPCS)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:DREAGER
Suffix:
Gender:F
Credentials:OTR/L, HPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 WELLS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-8868
Mailing Address - Country:US
Mailing Address - Phone:859-236-9513
Mailing Address - Fax:
Practice Address - Street 1:1844 WELLS LANDING RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-8868
Practice Address - Country:US
Practice Address - Phone:859-236-9513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYRO825225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics