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General NPI Number Information
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NPI Number | 1568533404
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Entity Type | Individual
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Provider Name | LUANNE HARRIS LEE LUANNE LEE MA
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Gender | Female
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4308 CARLISLE BLVD NE SUITE 203
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-4856
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Country | US
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Telephone | 505-450-9548
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Fax |
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Provider Business Mailing Address
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Address Line | 87 LENA CT
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City | CORRALES
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State | NM
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Zip | 87048-8555
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Country | US
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Telephone | 505-922-9548
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 006196
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License Number State | NM
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