Provider Demographics
NPI:1194017301
Name:LEE, FRANKLIN WINSTON
Entity Type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:WINSTON
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MARLOW
Mailing Address - State:OK
Mailing Address - Zip Code:73055-1614
Mailing Address - Country:US
Mailing Address - Phone:580-658-7020
Mailing Address - Fax:
Practice Address - Street 1:612 N 5TH ST
Practice Address - Street 2:
Practice Address - City:MARLOW
Practice Address - State:OK
Practice Address - Zip Code:73055-1614
Practice Address - Country:US
Practice Address - Phone:580-658-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health