Individual provider · Type 1 NPI

Mark Lisak

Occupational Therapy Assistant · Flagstaff, AZ

NPI number 1699600452 Active

Practice location

3112 E Butler Ave
Flagstaff, AZ 86004-0009

Call (860) 519-7902 Map

Fax (502) 212-8502

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X0047313 (AZ)

Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…

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About NPI 1699600452

Mark Lisak's National Provider Identifier is 1699600452, issued on Jun 15, 2026. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Flagstaff, AZ. The record was last updated on Jun 15, 2026.