Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 25494 | SC |
NPI | 1013671171 |
---|---|
Provider Name | Casey Lee |
First Address | Mount Pleasant, SC 29466-7577 |
Second Address | Mount Pleasant, SC 29464-3096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2021 |
Last Update Date | 26/10/2021 |