Provider Demographics
NPI:1942459375
Name:LEE, LANNIE (MA)
Entity Type:Individual
Prefix:
First Name:LANNIE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 HARVARD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7952
Mailing Address - Country:US
Mailing Address - Phone:617-249-4848
Mailing Address - Fax:
Practice Address - Street 1:39 HARVARD ST FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7952
Practice Address - Country:US
Practice Address - Phone:617-249-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor