Lisa Jean Wallace, COTA
NPI #1396368064 in North Plainfield, New Jersey
Provider Information
- NPI Number
- 1396368064
- Entity Type
- Individual
- Name
- Lisa Jean Wallace, COTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Occupational Therapy Assistant
- Credential
- COTA
- Enumeration Date
- May 28, 2020
- Last Updated
- May 28, 2020
Practice Location
- Address
- 480 SOMERSET ST UNIT 1
- City
- North Plainfield
- State
- New Jersey
- ZIP Code
- 07060-4018
- Phone
- (954) 292-3295
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapy Assistant |
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