Doctor Name: | MICHELE LEE |
NPI Number: | 1750409611 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | |
Business Practice Address: | 1190 Field St Dudley, GA - 310222123 |
Business Phone Number: | 4786763456 |
Business Fax Number: | |
Mailing Address: | 1190 Field St, DUDLEY |
State: | GA |
Postal Code: | 310222123 |
Phone Number: | 4786763456 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |