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Individual

LEE ANNE KRYSTLE RICO CHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
9715 HEALTHWAY DR, BERLIN, MD 21811-3500
(410) 641-4400
Mailing address
9892 SHORE BREAK LN APT 105, BERLIN, MD 21811-2971
(917) 514-4470

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
08263
MD
225X00000X
Occupational Therapist
OC013811
PA
225X00000X
Occupational Therapist
U1-0001898
DE

Other

Enumeration date
08/11/2019
Last updated
08/11/2019
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