Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1063816981 |
---|---|
Provider Name | Raneshia N Lee |
First Address | Horn Lake, MS 38637-3317 |
Second Address | Hernando, MS 38632-2634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2014 |
Last Update Date | 21/10/2014 |