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General NPI Number Information
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NPI Number | 1285285007
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Entity Type | Individual
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Provider Name | ALLISON MARIKO LEE MS
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Gender | Female
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Dates
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Enumeration Date | 09/23/2019
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 3100 NORIEGA ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-4046
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Country | US
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Telephone | 650-731-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 RIVERA ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-1710
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Country | US
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Telephone | 310-991-6462
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP27052
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License Number State | CA
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