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General NPI Number Information
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NPI Number | 1366659401
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Entity Type | Organization
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Legal Business Name | BONNIE M LEE & ASSOCIATES
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2200 DICKINSON ROAD UNIT 4B
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City | DE PERE
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State | WI
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Zip | 54115
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Country | US
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Telephone | 920-347-3502
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Fax | 920-347-3501
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Provider Business Mailing Address
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Address Line | 2200 DICKINSON ROAD UNIT 4B
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City | DE PERE
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State | WI
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Zip | 54115
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Country | US
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Telephone | 920-347-3502
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Fax | 920-347-3501
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. BONNIE MAE LEE
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Credential | MSW
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Telephone | 920-347-3502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2088
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License Number State | WI
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