Individual
ANGELA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7028 W LINCOLN ST, PEORIA, AZ 85345-6112
(623) 419-3652
Mailing address
20435 N 7TH ST, PHOENIX, AZ 85024-6024
(623) 419-3652
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
224Z00000X
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W2349 80498
AETNA
AZ
Enumeration date
03/08/2017
Last updated
04/26/2017
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