Provider Demographics
NPI:1033579859
Name:LEE, CAITLIN P
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:P
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CAITLIN
Other - Middle Name:P
Other - Last Name:JACOBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:7785 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:LOWVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13367-1229
Mailing Address - Country:US
Mailing Address - Phone:315-376-5225
Mailing Address - Fax:315-376-5061
Practice Address - Street 1:7785 N STATE ST
Practice Address - Street 2:
Practice Address - City:LOWVILLE
Practice Address - State:NY
Practice Address - Zip Code:13367-1229
Practice Address - Country:US
Practice Address - Phone:315-376-5225
Practice Address - Fax:315-376-5061
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018198225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist