Susan Mary Lee, OTR/L

Individual provider Active NPI Early Intervention Provider Agency · Tarentum, PA

NPI 1093487068 · NPPES record last updated Sep 29, 2021

Key facts

NPI
1093487068
Entity type
Individual (NPI type 1)
Primary specialty
Early Intervention Provider Agency 252Y00000X
License
OC003217L (PA)
Practice address
410 E 4TH Ave
Tarentum, PA 15084-1810
Phone
(724) 594-0676
Fax
(724) 594-0672
NPI assigned
Sep 29, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OC003217LPAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225X00000X OC003217L PA
Early Intervention Provider Agency 252Y00000X OC003217L PA Yes

Addresses

Primary practice location

410 E 4TH Ave
Tarentum, PA 15084-1810

Mailing address

410 E 4TH Ave
Tarentum, PA 15084-1810
Phone (724) 545-2740

Other providers in Tarentum, PA

All providers in Tarentum, PA · Early Intervention Provider Agency in Pennsylvania

Sources for this page

Verify at the official NPI Registry.