Provider Demographics
NPI:1447496229
Name:HORVATH, LISA M (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:M
Last Name:HORVATH
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 1:104 CARDINAL LN
Mailing Address - Street 2:
Mailing Address - City:TYNGSBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01879-1573
Mailing Address - Country:US
Mailing Address - Phone:603-321-7980
Mailing Address - Fax:
Practice Address - Street 1:104 CARDINAL LN
Practice Address - Street 2:
Practice Address - City:TYNGSBORO
Practice Address - State:MA
Practice Address - Zip Code:01879-1573
Practice Address - Country:US
Practice Address - Phone:603-321-7980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-27
Last Update Date:2008-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8763174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist