Provider Demographics
NPI:1043971286
Name:LEE, KATELYN SKY
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:SKY
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 MEYER WAY APT 7139
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1498
Mailing Address - Country:US
Mailing Address - Phone:682-888-7278
Mailing Address - Fax:
Practice Address - Street 1:102 E 3RD ST
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2949
Practice Address - Country:US
Practice Address - Phone:972-292-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-09
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health