Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 35.125326 | OH |
NPI | 1144546300 |
---|---|
Provider Name | Marissa Vawter-Lee |
First Address | Cincinnati, OH 45229-3039 |
Second Address | Cincinnati, OH 45229-3039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2010 |
Last Update Date | 11/07/2017 |