Provider Demographics
NPI:1063816981
Name:LEE, RANESHIA N (MSW)
Entity Type:Individual
Prefix:
First Name:RANESHIA
Middle Name:N
Last Name:LEE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:HORN LAKE
Mailing Address - State:MS
Mailing Address - Zip Code:38637-3317
Mailing Address - Country:US
Mailing Address - Phone:901-831-1739
Mailing Address - Fax:
Practice Address - Street 1:2725 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-2634
Practice Address - Country:US
Practice Address - Phone:662-449-1808
Practice Address - Fax:662-449-1811
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool