Provider Demographics
NPI:1578019402
Name:LEE, ELEANOR CATHERINE
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:CATHERINE
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 HORTON STREET
Mailing Address - Street 2:
Mailing Address - City:ZWOLLE
Mailing Address - State:LA
Mailing Address - Zip Code:71486
Mailing Address - Country:US
Mailing Address - Phone:318-550-6372
Mailing Address - Fax:
Practice Address - Street 1:8445 YOUREE DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2315
Practice Address - Country:US
Practice Address - Phone:318-550-6372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator