Provider Demographics
NPI:1053862946
Name:LEE, BINNA (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:BINNA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 CENTER AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5839
Mailing Address - Country:US
Mailing Address - Phone:917-504-6552
Mailing Address - Fax:
Practice Address - Street 1:2180 CENTER AVE APT 1A
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5839
Practice Address - Country:US
Practice Address - Phone:917-504-6552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist