Provider Demographics
NPI:1700111721
Name:LEE, DONGWOOK DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONGWOOK
Middle Name:DAVID
Last Name:LEE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 LANGFORD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-4772
Mailing Address - Country:US
Mailing Address - Phone:404-919-6884
Mailing Address - Fax:
Practice Address - Street 1:3000 LANGFORD RD STE 300
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30071-4772
Practice Address - Country:US
Practice Address - Phone:404-919-6884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2023-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE731103T00000X
GA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist