Provider Demographics
NPI:1558814343
Name:LEE, XOU
Entity Type:Individual
Prefix:
First Name:XOU
Middle Name:
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 1:2185 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-5312
Mailing Address - Country:US
Mailing Address - Phone:530-538-8221
Mailing Address - Fax:530-532-0713
Practice Address - Street 1:2185 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-5312
Practice Address - Country:US
Practice Address - Phone:530-538-8221
Practice Address - Fax:530-532-0713
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health