Lillis, Agusta
Lillis, Agusta is an individual health care provider with primary practice located at 910 Summer St , Eau Claire WI 54701-4240. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Lillis, Agusta can be contacted via phone (715) 379-1268.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 3653 | Wisconsin |
Profile Details
| NPI number | 1184715492 |
|---|---|
| LBN Legal business name | Lillis, Agusta |
| Credentials | Registered Occupational Therapist (OTR) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Apr 10th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184715492 | NPPES |
| Minnesota | Other | 6402271 | MEDICA |
| Minnesota | Other | 017M7LI | MEDICA |
| Minnesota | MEDICAID | 41810700 | MEDICA |
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