Provider Demographics
NPI:1043598790
Name:LEE, ASHLEY (LISW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:HANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-9407
Mailing Address - Country:US
Mailing Address - Phone:319-752-4000
Mailing Address - Fax:319-758-6650
Practice Address - Street 1:400 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-9407
Practice Address - Country:US
Practice Address - Phone:319-752-4000
Practice Address - Fax:319-758-6650
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0072611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical