Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 04823 | MD |
Y | 103T00000X | Psychologist | 04823 | MD |
NPI | 1003104944 |
---|---|
Provider Name | Dr. Stephanie A Lee |
First Address | Baltimore, MD 21213-3939 |
Second Address | Baltimore, MD 21205-1832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2011 |
Last Update Date | 13/07/2011 |