Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 10295 | NC |
N | 225X00000X | Occupational Therapist | T5976 | KY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 10295 | NC |
NPI | 1023426178 |
---|---|
Provider Name | Chelsea Lee |
First Address | Youngsville, NC 27596-7890 |
Second Address | Youngsville, NC 27596-7890 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2014 |
Last Update Date | 15/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19JOS | BCBS (01) | NC |