Doctor Name: | MS. BONNIE MAE LEE |
NPI Number: | 1144310194 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | 3093-123 |
Business Practice Address: | 2200 Dickinson Road Unit 4 B De Pere, WI - 54115 |
Business Phone Number: | 9203473500 |
Business Fax Number: | 9203473501 |
Mailing Address: | 3759 Park Rd, GREENLEAF |
State: | WI |
Postal Code: | 541269323 |
Phone Number: | 9208642809 |
Fax Number: | |
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: | 1041C0700X |
License Number: | 3093-123 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |