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General NPI Number Information
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NPI Number | 1790258382
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Entity Type | Organization
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Legal Business Name | ANNE H. LEE INDIVIDUAL COUPLES & FAMILY THERAPY, INC
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 23832 ROCKFIELD BLVD STE 130
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City | LAKE FOREST
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State | CA
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Zip | 92630-2860
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Country | US
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Telephone | 949-689-8272
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Fax |
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Provider Business Mailing Address
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Address Line | 25422 TRABUCO RD STE 105-210
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City | LAKE FOREST
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State | CA
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Zip | 92630-2791
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Country | US
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Telephone | 949-689-8272
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ANNE HON LEE
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Credential | MS, RDN, LMFT
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Telephone | 949-689-8272
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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 |
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License Number State |
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