Provider Demographics
NPI:1477291532
Name:LEE, TIFFANY E (OTD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:E
Last Name:LEE
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 SUNSET RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7149
Mailing Address - Country:US
Mailing Address - Phone:662-416-7274
Mailing Address - Fax:
Practice Address - Street 1:201 E LINCOLN ST STE I
Practice Address - Street 2:
Practice Address - City:LINDSBORG
Practice Address - State:KS
Practice Address - Zip Code:67456-2406
Practice Address - Country:US
Practice Address - Phone:785-546-0665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-03901225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist