Provider Demographics
NPI:1043335789
Name:LEE, MIHYUNG (MFC)
Entity Type:Individual
Prefix:
First Name:MIHYUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MFC
Other - Prefix:
Other - First Name:MIHYUNG
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFC
Mailing Address - Street 1:7003 N FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-1247
Mailing Address - Country:US
Mailing Address - Phone:323-543-4222
Mailing Address - Fax:323-543-4239
Practice Address - Street 1:7003 N FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-1247
Practice Address - Country:US
Practice Address - Phone:323-543-4222
Practice Address - Fax:323-543-4239
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC53200106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist