Provider Demographics
NPI:1093043879
Name:CALLAGHER, LEE ANN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LEE
Middle Name:ANN
Last Name:CALLAGHER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:LEE
Other - Middle Name:ANN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:807 WILBRAHAM ROAD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109
Mailing Address - Country:US
Mailing Address - Phone:413-782-1800
Mailing Address - Fax:413-782-8852
Practice Address - Street 1:807 WILBRAHAM RD.
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109
Practice Address - Country:US
Practice Address - Phone:413-782-1800
Practice Address - Fax:413-782-8852
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOT5518225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist