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General NPI Number Information
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NPI Number | 1548999501
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Entity Type | Individual
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Provider Name | JANNIS LEE
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Gender | Female
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 1132 BISHOP ST UNIT 1710
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City | HONOLULU
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State | HI
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Zip | 96813-2894
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Country | US
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Telephone | 909-260-6162
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Fax |
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Provider Business Mailing Address
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Address Line | 3784 MISSION AVE # 148-343
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City | OCEANSIDE
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State | CA
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Zip | 92058-1460
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Country | US
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Telephone | 909-260-6162
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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 | 2121
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License Number State | HI
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