Provider Demographics
NPI:1811588601
Name:LEE, CHARMAINE TING
Entity Type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:TING
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 1:431 EVERETT AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-3472
Mailing Address - Country:US
Mailing Address - Phone:626-215-3941
Mailing Address - Fax:
Practice Address - Street 1:529 E LIVE OAK AVE STE E
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5600
Practice Address - Country:US
Practice Address - Phone:626-539-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty