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Individual

ANGEL LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
4324 212TH ST, BAYSIDE, NY 11361-2851
(347) 493-9267
Mailing address
4324 212TH ST, BAYSIDE, NY 11361-2851
(347) 493-9267

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13765
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13765
BOARD OF OCCUPATIONAL THERAPY
CA
Enumeration date
09/10/2013
Last updated
09/10/2013
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