| Doctor Name: | RUSSELL F LEE |
| NPI Number: | 1023263456 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | E.D., LP |
| License Number: | LP1813 |
| Business Practice Address: | 722 15th St Nw Bemidji, MN - 566012528 |
| Business Phone Number: | 2187513280 |
| Business Fax Number: | 2187513298 |
| Mailing Address: | 722 15th St Nw, BEMIDJI |
| State: | MN |
| Postal Code: | 566012528 |
| Phone Number: | 2187513280 |
| Fax Number: | 2187513298 |
| NPI Enumeration Date: | 11/26/2008 |
| NPI Last Update Date: | 11/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | LP1813 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |