Provider Demographics
NPI:1598132631
Name:LEE, APRIL (COTA)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 FAIRVIEW RD
Mailing Address - Street 2:166
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-6760
Mailing Address - Country:US
Mailing Address - Phone:864-376-3160
Mailing Address - Fax:
Practice Address - Street 1:630 FAIRVIEW RD
Practice Address - Street 2:166
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-6760
Practice Address - Country:US
Practice Address - Phone:864-376-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3380224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant