Provider Demographics
NPI:1841570660
Name:DIIORIO, LISA RAE (COTA/L)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:RAE
Last Name:DIIORIO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ALFRED DR
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-2444
Mailing Address - Country:US
Mailing Address - Phone:401-529-8346
Mailing Address - Fax:
Practice Address - Street 1:13 ALFRED DR
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2444
Practice Address - Country:US
Practice Address - Phone:401-529-8346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOTA00300172V00000X
MA3057172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker