Provider Demographics
NPI:1346772829
Name:JOCELYN A. LEE, PHD
Entity Type:Organization
Organization Name:JOCELYN A. LEE, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:352-331-0020
Mailing Address - Street 1:2653 SW 87TH DR STE A
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-9382
Mailing Address - Country:US
Mailing Address - Phone:352-331-0020
Mailing Address - Fax:352-331-0022
Practice Address - Street 1:2653 SW 87TH DR STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-9382
Practice Address - Country:US
Practice Address - Phone:352-331-0020
Practice Address - Fax:352-331-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8089103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ04THOtherMEDICARE PTAN