Provider Demographics
NPI:1912534389
Name:LEE, KATARINA
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:
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 1:7041 W MELINDA LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-9513
Mailing Address - Country:US
Mailing Address - Phone:623-252-7564
Mailing Address - Fax:
Practice Address - Street 1:50 OLD VILLAGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1583
Practice Address - Country:US
Practice Address - Phone:614-544-1976
Practice Address - Fax:614-544-1981
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program