MEDICARE: MRS. LEE ELIZABETH MCAFEE MOT, OTR/L

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	225XN1300X	Neurorehabilitation Occupational Therapist	113538	TX

General Provider Information

NPI Number	:	1831469121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEE ELIZABETH MCAFEE MOT, OTR/L

Provider Business Mailing Address
First Line	:	8488 BANQUO DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-5836
Country	:	US
Telephone Number	:	646-319-2691
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 GASTON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2018
Country	:	US
Telephone Number	:	214-820-9617
Fax Number	:

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

Provider Enumeration Date	:	01/04/2012
Last Update Date	:	01/04/2012

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