Provider Demographics
NPI:1538686704
Name:LEE, DELIANN S (CNA,HHA,BEHAVIORAL)
Entity Type:Individual
Prefix:
First Name:DELIANN
Middle Name:S
Last Name:LEE
Suffix:
Gender:F
Credentials:CNA,HHA,BEHAVIORAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 VENICE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-3033
Mailing Address - Country:US
Mailing Address - Phone:781-666-3655
Mailing Address - Fax:
Practice Address - Street 1:6 VENICE AVE APT 1
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-3033
Practice Address - Country:US
Practice Address - Phone:857-504-5639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst