Doctor Name: | DEREK LEE |
NPI Number: | 1356636070 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PC |
License Number: | C0900398 |
Business Practice Address: | 1045 Klotz Rd Bowling Green, OH - 434024820 |
Business Phone Number: | 4193527588 |
Business Fax Number: | 4193544977 |
Mailing Address: | 26494 Laurel Ln, PERRYSBURG |
State: | OH |
Postal Code: | 435515484 |
Phone Number: | 4198748798 |
Fax Number: | |
NPI Enumeration Date: | 06/10/2011 |
NPI Last Update Date: | 05/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | C0900398 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |