Provider Demographics
NPI:1396021283
Name:LEE, DARLENE YVETTE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:YVETTE
Last Name:LEE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 S KING ST STE 1564
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2072
Mailing Address - Country:US
Mailing Address - Phone:808-721-6106
Mailing Address - Fax:808-591-9343
Practice Address - Street 1:1314 S KING ST STE 1564
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2072
Practice Address - Country:US
Practice Address - Phone:808-721-6106
Practice Address - Fax:808-591-9343
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2958174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist