Provider Demographics
NPI:1023490521
Name:LEE, KARLEAH U (CRT HAIR LOSS SPEC)
Entity type:Individual
Prefix:
First Name:KARLEAH
Middle Name:U
Last Name:LEE
Suffix:
Gender:F
Credentials:CRT HAIR LOSS SPEC
Other - Prefix:
Other - First Name:KARLEAH
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRT HAIR LOSS SPEC
Mailing Address - Street 1:1519 AUTUMN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-6662
Mailing Address - Country:US
Mailing Address - Phone:804-243-1606
Mailing Address - Fax:
Practice Address - Street 1:1519 AUTUMN WOODS DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-6662
Practice Address - Country:US
Practice Address - Phone:804-243-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA12040186741744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management