Provider Demographics
NPI:1497935969
Name:LEE, STARR K
Entity Type:Individual
Prefix:MR
First Name:STARR
Middle Name:K
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 1:4264 W ROCHDALE LN APT 206
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-8598
Mailing Address - Country:US
Mailing Address - Phone:714-312-6339
Mailing Address - Fax:
Practice Address - Street 1:4264 W ROCHDALE LN APT 206
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8598
Practice Address - Country:US
Practice Address - Phone:714-312-6339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88859106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist