Provider Demographics
NPI:1720211402
Name:LEE, ANNA KAY
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KAY
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2432 W PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4726
Mailing Address - Country:US
Mailing Address - Phone:602-626-8851
Mailing Address - Fax:602-865-8020
Practice Address - Street 1:2432 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4726
Practice Address - Country:US
Practice Address - Phone:602-626-8851
Practice Address - Fax:602-865-8020
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2010-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ68722355A2700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant