Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | LE75460 | IN |
NPI | 1134264443 |
---|---|
Provider Name | Dr. Shirley Marie Lee |
First Address | Orlando, FL 32810-2255 |
Second Address | Orlando, FL 32808-7123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 14/05/2009 |