Provider Demographics
NPI:1013392638
Name:BATHA, LEE (TLMHC)
Entity Type:Individual
Prefix:MRS
First Name:LEE
Middle Name:
Last Name:BATHA
Suffix:
Gender:F
Credentials:TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 CLERMONT DR
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-2349
Mailing Address - Country:US
Mailing Address - Phone:563-260-6142
Mailing Address - Fax:
Practice Address - Street 1:3110 CLERMONT DR
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-2349
Practice Address - Country:US
Practice Address - Phone:563-260-6142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health