Provider Demographics
NPI:1649722729
Name:LEES, TERESA (MS)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:LEES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4948 E 45TH ST N
Mailing Address - Street 2:
Mailing Address - City:BEL AIRE
Mailing Address - State:KS
Mailing Address - Zip Code:67220-1507
Mailing Address - Country:US
Mailing Address - Phone:816-801-0556
Mailing Address - Fax:
Practice Address - Street 1:8340 E 21ST ST N
Practice Address - Street 2:900
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2961
Practice Address - Country:US
Practice Address - Phone:816-801-0556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2018-41938225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist