Provider Demographics
NPI:1841613304
Name:WINSLOW, LEE
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:WINSLOW
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 1:170 E ALTAMIRA DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3509
Mailing Address - Country:US
Mailing Address - Phone:435-586-0213
Mailing Address - Fax:
Practice Address - Street 1:170 E ALTAMIRA DR
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3509
Practice Address - Country:US
Practice Address - Phone:435-586-0213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator