Provider Demographics
NPI:1780139923
Name:MESSEL, LISA DIANE (OTR)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:DIANE
Last Name:MESSEL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4034 BOHANNON CT
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-9266
Mailing Address - Country:US
Mailing Address - Phone:812-457-6226
Mailing Address - Fax:
Practice Address - Street 1:4088 FRAME RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2258
Practice Address - Country:US
Practice Address - Phone:812-853-9567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000950A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist