MEDICARE: TONYA DENISE LEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1366233389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA DENISE LEE

Provider Business Mailing Address
First Line	:	4773 PRICE ST
Second Line	:
City	:	FOREST PARK
State	:	GA
Zip	:	30297-1951
Country	:	US
Telephone Number	:	719-964-1281
Fax Number	:

Provider Business Practice Location Address
First Line	:	4773 PRICE ST
Second Line	:
City	:	FOREST PARK
State	:	GA
Zip	:	30297-1951
Country	:	US
Telephone Number	:	719-964-1281
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2025
Last Update Date	:	06/14/2026

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Directions to “ TONYA DENISE LEE ” Practice Location

Language	Start Address	Practice Location

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