Provider Demographics
NPI:1013031939
Name:LEE, MARTHA JEAN (PHD, NCSP, LSSP)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:JEAN
Last Name:LEE
Suffix:
Gender:F
Credentials:PHD, NCSP, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 PLOVER DR
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-2547
Mailing Address - Country:US
Mailing Address - Phone:713-826-1412
Mailing Address - Fax:
Practice Address - Street 1:4512 HIGHWAY 3
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-6858
Practice Address - Country:US
Practice Address - Phone:281-229-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30803103TC2200X
TX31020103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool