| Doctor Name: | MR. GREGORY RAYMOND LEE |
| NPI Number: | 1053665760 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.P.C. |
| License Number: | LPC-5128 |
| Business Practice Address: | 1200 W Ironwood Dr Suite 101 Coeur D Alene, ID - 838142660 |
| Business Phone Number: | 2086649729 |
| Business Fax Number: | |
| Mailing Address: | 1200 W Ironwood Dr, Suite 101 COEUR D ALENE |
| State: | ID |
| Postal Code: | 838142660 |
| Phone Number: | 2086649729 |
| Fax Number: | |
| NPI Enumeration Date: | 11/02/2012 |
| NPI Last Update Date: | 11/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC-5128 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |