Doctor Name: | SU JIN LEE |
NPI Number: | 1730528373 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 17738 |
Business Practice Address: | 298 Clear Sky Ct Ste G Clarksville, TN - 370435685 |
Business Phone Number: | 9315422739 |
Business Fax Number: | |
Mailing Address: | 550 New South Dr Apt 1207, CLARKSVILLE |
State: | TN |
Postal Code: | 370438429 |
Phone Number: | 8134358328 |
Fax Number: | |
NPI Enumeration Date: | 06/17/2013 |
NPI Last Update Date: | 06/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 17738 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |