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General NPI Number Information
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NPI Number | 1780233387
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Entity Type | Individual
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Provider Name | LEE LOUIS CAVELLINI OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 19829 N 27TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85027-4001
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Country | US
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Telephone | 623-580-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 6480 N 82ND ST APT 133
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-5665
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Country | US
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Telephone | 707-332-5779
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT.0005367
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License Number State | CO
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