Provider Demographics
NPI:1750023107
Name:JANET MENTORE LEE, PH.D., PLLC
Entity Type:Organization
Organization Name:JANET MENTORE LEE, PH.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:MENTORE
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-832-4237
Mailing Address - Street 1:124 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-3511
Mailing Address - Country:US
Mailing Address - Phone:203-832-4237
Mailing Address - Fax:
Practice Address - Street 1:124 WOODRIDGE DR
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-3511
Practice Address - Country:US
Practice Address - Phone:203-832-4237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE