Provider Demographics
NPI:1649249350
Name:LIVIGNI, LISA (LOTR)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:LIVIGNI
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 MERCEDES DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5154
Mailing Address - Country:US
Mailing Address - Phone:318-388-1303
Mailing Address - Fax:318-388-1707
Practice Address - Street 1:3130 MERCEDES DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5154
Practice Address - Country:US
Practice Address - Phone:318-388-1303
Practice Address - Fax:318-388-1707
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ11359225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics