Individual
DIANE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
506 E 4TH ST, SUTHERLAND, IA 51058-7668
(712) 446-3857
Mailing address
406 LAKE ST, ALTA, IA 51002-1453
(712) 200-3103
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
01444
IA
224Z00000X
Occupational Therapy Assistant
1134
NE
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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