Provider Demographics
NPI:1447684436
Name:MARY E. LEE, THERAPY, L.L.C.
Entity type:Organization
Organization Name:MARY E. LEE, THERAPY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-232-2051
Mailing Address - Street 1:600 5TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6085
Mailing Address - Country:US
Mailing Address - Phone:515-232-2051
Mailing Address - Fax:515-232-2775
Practice Address - Street 1:600 5TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6085
Practice Address - Country:US
Practice Address - Phone:515-232-2051
Practice Address - Fax:515-232-2775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00203251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health