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General NPI Number Information
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NPI Number | 1891182101
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Entity Type | Individual
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Provider Name | VANESSA LEE
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Gender | Female
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 3133 N MILLBROOK AVE
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City | FRESNO
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State | CA
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Zip | 93703-1425
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Country | US
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Telephone | 559-593-3544
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Fax |
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Provider Business Mailing Address
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Address Line | 290 SEMINOLE WAY
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City | LEMOORE
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State | CA
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Zip | 93245-3817
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Country | US
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Telephone | 559-593-3544
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ASW61624
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License Number State | CA
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