| Doctor Name: | AMANDA LEE |
| NPI Number: | 1073752192 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | P9401004 |
| Business Practice Address: | 309 E Race Ave Searcy, AR - 721434331 |
| Business Phone Number: | 5013052359 |
| Business Fax Number: | 5013052348 |
| Mailing Address: | 4508 Stadium Blvd, JONESBORO |
| State: | AR |
| Postal Code: | 724049675 |
| Phone Number: | 8709336886 |
| Fax Number: | 8709339395 |
| NPI Enumeration Date: | 02/12/2009 |
| NPI Last Update Date: | 02/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | P9401004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |