Provider Demographics
NPI:1144395005
Name:LEE, GAIL ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:ANN
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:505 RAYBURN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1609
Mailing Address - Country:US
Mailing Address - Phone:314-909-0246
Mailing Address - Fax:314-968-0581
Practice Address - Street 1:9051 WATSON RD
Practice Address - Street 2:SUITE 331
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-2240
Practice Address - Country:US
Practice Address - Phone:314-761-9157
Practice Address - Fax:314-968-0581
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0041231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical