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General NPI Number Information
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NPI Number | 1447684436
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Entity Type | Organization
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Legal Business Name | MARY E. LEE, THERAPY, L.L.C.
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Dates
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Enumeration Date | 08/26/2013
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 600 5TH ST SUITE 200
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City | AMES
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State | IA
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Zip | 50010-6085
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Country | US
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Telephone | 515-232-2051
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Fax | 515-232-2775
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Provider Business Mailing Address
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Address Line | 600 5TH ST SUITE 200
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City | AMES
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State | IA
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Zip | 50010-6085
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Country | US
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Telephone | 515-232-2051
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Fax | 515-232-2775
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. MARY E. LEE
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Credential | LISW
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Telephone | 515-232-2051
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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 | 00203
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License Number State | IA
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