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General NPI Number Information
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NPI Number | 1811562457
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Entity Type | Individual
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Provider Name | KATHRYN LEE LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | PO BOX 99180
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City | YUMA
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State | AZ
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Zip | 85369-9180
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Country | US
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Telephone | 928-269-2425
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Fax |
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Provider Business Mailing Address
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Address Line | 5314 ALVIE ST
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City | CHARLESTON
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State | SC
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Zip | 29418-5802
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 59781
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License Number State | TX
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