Doctor Name: | MRS. MELISSA LEE |
NPI Number: | 1023108727 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 43804 |
Business Practice Address: | 555 Northgate Dr Family Service Agency Of Marin San Rafael, CA - 949033680 |
Business Phone Number: | 4154915700 |
Business Fax Number: | 4154915750 |
Mailing Address: | 555 Northgate Dr, Family Service Agency Of Marin SAN RAFAEL |
State: | CA |
Postal Code: | 949033680 |
Phone Number: | 4154915700 |
Fax Number: | 4154915750 |
NPI Enumeration Date: | 10/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 43804 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |