MEDICARE: MS. LEE ANN ORTON LPC

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	101YP2500X	Professional Counselor	5118674-6004	UT

General Provider Information

NPI Number	:	1770705519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEE ANN ORTON LPC

Provider Business Mailing Address
First Line	:	827 E 900 S
Second Line	:
City	:	MAPLETON
State	:	UT
Zip	:	84664-5035
Country	:	US
Telephone Number	:	801-489-7444
Fax Number	:	801-489-9141

Provider Business Practice Location Address
First Line	:	827 E 900 S
Second Line	:
City	:	MAPLETON
State	:	UT
Zip	:	84664-5035
Country	:	US
Telephone Number	:	801-489-7444
Fax Number	:	801-489-9141

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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