Provider Demographics
NPI:1407085194
Name:LEE, JAMES HENRY IV (MS CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HENRY
Last Name:LEE
Suffix:IV
Gender:M
Credentials:MS CCC-SLP
Other - Prefix:MR
Other - First Name:JIMMY
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:800 FLORIDA AVE NE
Mailing Address - Street 2:SLCC 2212
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3600
Mailing Address - Country:US
Mailing Address - Phone:202-651-5665
Mailing Address - Fax:202-651-5324
Practice Address - Street 1:800 FLORIDA AVE NE
Practice Address - Street 2:SLCC 2212
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3600
Practice Address - Country:US
Practice Address - Phone:202-651-5665
Practice Address - Fax:202-651-5324
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist