Provider Demographics
NPI:1376932723
Name:LEE, CARRIE MARIE
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:MARIE
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CARRIE
Other - Middle Name:M
Other - Last Name:KARKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8670 DEVONSHIRE CT APT 304
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4528
Mailing Address - Country:US
Mailing Address - Phone:706-225-2754
Mailing Address - Fax:
Practice Address - Street 1:500 MONTGOMERY ST
Practice Address - Street 2:SUITE 400
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1565
Practice Address - Country:US
Practice Address - Phone:706-225-2754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator