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General NPI Number Information
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NPI Number | 1902622251
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Entity Type | Individual
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Provider Name | HAE IN LEE
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 4401 SEPULVEDA BLVD UNIT 210
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3934
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Country | US
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Telephone | 424-218-9880
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Fax |
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Provider Business Mailing Address
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Address Line | 12420 WOODGREEN ST APT 108
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City | LOS ANGELES
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State | CA
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Zip | 90066-2770
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Country | US
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Telephone | 424-382-4651
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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