Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 7216 | TN |
NPI | 1003002924 |
---|---|
Provider Name | Miss Nancy Carol Lee |
First Address | Durham, NC 27705-3875 |
Second Address | Durham, NC 27705-3875 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2007 |
Last Update Date | 25/09/2007 |