| Doctor Name: | MS. OPHELIA RENEE LEE-FERGUSON |
| NPI Number: | 1154336980 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LPC003539 |
| Business Practice Address: | 1636 Connally Dr East Point, GA - 303442558 |
| Business Phone Number: | 4047624042 |
| Business Fax Number: | 4047623114 |
| Mailing Address: | 2121 Chevy Chase Ln, DECATUR |
| State: | GA |
| Postal Code: | 300326122 |
| Phone Number: | 4042884205 |
| Fax Number: | |
| NPI Enumeration Date: | 07/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC003539 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |