Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 3366 | HI |
NPI | 1003008392 |
---|---|
Provider Name | Ms. Lynette Lee |
First Address | Honolulu, HI 96816-0922 |
Second Address | Honolulu, HI 96813-4604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2007 |
Last Update Date | 10/08/2007 |