| Doctor Name: | SUSAN LEE |
| NPI Number: | 1003230657 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SW2323 |
| Business Practice Address: | 12086 Ft.caroline Rd Suite 401 Jacksonville, FL - 322251536 |
| Business Phone Number: | 9045651271 |
| Business Fax Number: | 9046457325 |
| Mailing Address: | 12086 Fort Caroline Rd, JACKSONVILLE |
| State: | FL |
| Postal Code: | 322252687 |
| Phone Number: | 9045651271 |
| Fax Number: | 9046457325 |
| NPI Enumeration Date: | 02/18/2014 |
| NPI Last Update Date: | 06/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW2323 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |