Provider Demographics
NPI:1518533249
Name:KATHLEEN LEE, AU. D., PLLC
Entity Type:Organization
Organization Name:KATHLEEN LEE, AU. D., PLLC
Other - Org Name:CONCIERGE AUDIOLOGY LAS VEGAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:JYONG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:702-706-4358
Mailing Address - Street 1:10161 W. PARK RUN DRIVE
Mailing Address - Street 2:STE 150
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145
Mailing Address - Country:US
Mailing Address - Phone:702-706-4358
Mailing Address - Fax:
Practice Address - Street 1:10161 W. PARK RUN DRIVE
Practice Address - Street 2:STE 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145
Practice Address - Country:US
Practice Address - Phone:702-706-4358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty