Provider Demographics
NPI:1750798617
Name:LISI, SARAH (OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LISI
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 1:348 HATFIELD ST
Mailing Address - Street 2:APT D
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2563
Mailing Address - Country:US
Mailing Address - Phone:401-932-6800
Mailing Address - Fax:
Practice Address - Street 1:348 HATFIELD ST
Practice Address - Street 2:APT D
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2563
Practice Address - Country:US
Practice Address - Phone:401-932-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10648225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist