Provider Demographics
NPI:1336264563
Name:LEE, CHIHCHEN SOPHIA (LPMT, MT-BC)
Entity Type:Individual
Prefix:DR
First Name:CHIHCHEN
Middle Name:SOPHIA
Last Name:LEE
Suffix:
Gender:F
Credentials:LPMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 PLAINS AVE
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-2514
Mailing Address - Country:US
Mailing Address - Phone:580-772-5354
Mailing Address - Fax:580-772-5354
Practice Address - Street 1:100 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-3001
Practice Address - Country:US
Practice Address - Phone:580-774-3218
Practice Address - Fax:580-774-3714
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK01225A00000X
PA04364225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1OtherLICCENSED PROFESSIONAL MUSIC THERAPIST