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General NPI Number Information
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NPI Number | 1649856881
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Entity Type | Individual
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Provider Name | LEE ANNE BARBARA MAED, MA, LAC
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Gender | Female
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Dates
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Enumeration Date | 03/18/2021
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 13060 S SUNLAND GIN RD
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City | ARIZONA CITY
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State | AZ
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Zip | 85123-8448
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Country | US
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Telephone | 520-387-5651
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Fax |
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Provider Business Mailing Address
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Address Line | 410 N MALACATE ST
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City | AJO
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State | AZ
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Zip | 85321-2254
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Country | US
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Telephone | 520-387-5651
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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