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General NPI Number Information
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NPI Number | 1851795983
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Entity Type | Individual
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Provider Name | SU LI LEE LCP
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Gender | Female
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 108 N PAYNE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2906
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Country | US
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Telephone | 301-767-1733
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 JEFFERSON DAVIS HWY STE 511
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City | ARLINGTON
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State | VA
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Zip | 22202-3603
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Country | US
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Telephone | 703-416-1441
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810004793
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License Number State | VA
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