Provider Demographics
NPI:1861815334
Name:LEE, MARIA (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 W CHARLESTON BLVD STE 38D
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1934
Mailing Address - Country:US
Mailing Address - Phone:702-877-0808
Mailing Address - Fax:702-878-1322
Practice Address - Street 1:2820 W CHARLESTON BLVD STE 38D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1934
Practice Address - Country:US
Practice Address - Phone:702-877-0808
Practice Address - Fax:702-878-1322
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP1416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist