Provider Demographics
NPI:1649397563
Name:MILLER, LISA ERIN (MOT, OTR)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ERIN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 HECLA DR STE D130
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2318
Mailing Address - Country:US
Mailing Address - Phone:303-963-5582
Mailing Address - Fax:
Practice Address - Street 1:1371 HECLA DR STE D130
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2318
Practice Address - Country:US
Practice Address - Phone:303-963-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111422225X00000X
COOT.0008625225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist