Provider Demographics
NPI:1538246368
Name:RABANT, LISA M (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:RABANT
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:RUSSICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:776 NW WATERLILY PL
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-3504
Mailing Address - Country:US
Mailing Address - Phone:772-708-6454
Mailing Address - Fax:772-692-4198
Practice Address - Street 1:11380 PROSPERITY FARMS RD
Practice Address - Street 2:STE 109
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3474
Practice Address - Country:US
Practice Address - Phone:561-803-7761
Practice Address - Fax:561-803-7762
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 5752225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand