Provider Demographics
NPI:1275693897
Name:BIEBER, LEE ANN
Entity Type:Individual
Prefix:MRS
First Name:LEE
Middle Name:ANN
Last Name:BIEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LEE
Other - Middle Name:ANN
Other - Last Name:BROUILLETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44571 W GRANITE DR
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85239
Mailing Address - Country:US
Mailing Address - Phone:520-568-5757
Mailing Address - Fax:520-568-5822
Practice Address - Street 1:44571 W GRANITE DR
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85239
Practice Address - Country:US
Practice Address - Phone:520-568-5757
Practice Address - Fax:520-568-5822
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4175385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child