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NPI Code Detail

MEDICARE: MI NA LEE

MEDICARE: MI NA 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
1106H00000XMarriage & Family TherapistM.2400326OH

General Provider Information

NPI Number : 1790477784
Entity Type Code : Individual
Provider Name (Legal Business Name) : MI NA LEE
Provider Business Mailing Address
First Line : 1777 E DUBLIN GRANVILLE RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-3502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1777 E DUBLIN GRANVILLE RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-3502
Country : US
Telephone Number : 614-355-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2023
Last Update Date : 08/08/2024

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Directions to “ MI NA LEE ” Practice Location

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