Provider Demographics
NPI:1437693454
Name:WESTOVER, LEE ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:ANN
Last Name:WESTOVER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4744 VERNON BLVD APT 3L
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5553
Mailing Address - Country:US
Mailing Address - Phone:917-224-6707
Mailing Address - Fax:
Practice Address - Street 1:4744 VERNON BLVD APT 3L
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5553
Practice Address - Country:US
Practice Address - Phone:917-224-6707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021024225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist