Provider Demographics
NPI:1871036848
Name:LEE, SAVANNAH VICTORIA (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:VICTORIA
Last Name:LEE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MARLBORO RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1254
Mailing Address - Country:US
Mailing Address - Phone:302-943-7500
Mailing Address - Fax:
Practice Address - Street 1:55 TOZER RD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5515
Practice Address - Country:US
Practice Address - Phone:978-969-2894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12155225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist