Kelsey Lynn Lee

Individual provider Active NPI Developmental Therapist · Noble, IL

NPI 1962834754 · NPPES record last updated Aug 2, 2013

Key facts

NPI
1962834754
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
103 Oak St
Noble, IL 62868-1904
Phone
(217) 891-3743
NPI assigned
Aug 2, 2013
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Yes

Addresses

Primary practice location

103 Oak St
Noble, IL 62868-1904

Mailing address

103 Oak St
Noble, IL 62868-1904

Other providers in Noble, IL

All providers in Noble, IL · Developmental Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.