Doctor Name: | MRS. LAURA LEE |
NPI Number: | 1023349016 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | MH5747 |
Business Practice Address: | 225 S Swoope Ave Suite 211 Maitland, FL - 327515704 |
Business Phone Number: | 4076220444 |
Business Fax Number: | 4076990444 |
Mailing Address: | 225 S Swoope Ave, Suite 211 MAITLAND |
State: | FL |
Postal Code: | 327515704 |
Phone Number: | 4076220444 |
Fax Number: | 4076990444 |
NPI Enumeration Date: | 01/15/2010 |
NPI Last Update Date: | 02/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH5747 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |