Individual
TINA E LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2492 SILVER RUN RD, POPLARVILLE, MS 39470-3491
(601) 916-7752
Mailing address
2492 SILVER RUN RD, POPLARVILLE, MS 39470-3491
(601) 916-7752
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211219
TX
224Z00000X
Occupational Therapy Assistant
OTA 12143
FL
224Z00000X
Occupational Therapy Assistant
TA2655
MS
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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