MEDICARE: ANNA KAY LEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355A2700X	Audiology Assistant	6872	AZ

General Provider Information

NPI Number	:	1720211402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA KAY LEE

Provider Business Mailing Address
First Line	:	2432 W PEORIA AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4726
Country	:	US
Telephone Number	:	602-626-8851
Fax Number	:	602-865-8020

Provider Business Practice Location Address
First Line	:	2432 W PEORIA AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4726
Country	:	US
Telephone Number	:	602-626-8851
Fax Number	:	602-865-8020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2009
Last Update Date	:	09/25/2010

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Directions to “ ANNA KAY LEE ” Practice Location

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