Doctor Name: | MRS. BRENDA K. LEE |
NPI Number: | 1003026543 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPT / MHS |
License Number: | PT28096 |
Business Practice Address: | 11951 Hesperia Rd Hesperia, CA - 923451855 |
Business Phone Number: | 7609562345 |
Business Fax Number: | 7609563761 |
Mailing Address: | 11951 Hesperia Rd, HESPERIA |
State: | CA |
Postal Code: | 923451855 |
Phone Number: | 7609562345 |
Fax Number: | 7609563761 |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 09/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | PT28096 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |