Provider Demographics
NPI:1740294339
Name:EBY, LISA MICHELLE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MICHELLE
Last Name:EBY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 GRANITE RUN DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6823
Mailing Address - Country:US
Mailing Address - Phone:717-735-3600
Mailing Address - Fax:717-735-3604
Practice Address - Street 1:231 GRANITE RUN DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6823
Practice Address - Country:US
Practice Address - Phone:717-735-3600
Practice Address - Fax:717-735-3604
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000897I225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50078842OtherCAPITAL BLUECROSS