Provider Demographics
NPI:1750592812
Name:LEE, STEPHEN MONROE (MA, MT-BC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:MONROE
Last Name:LEE
Suffix:
Gender:M
Credentials:MA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5497 TWIN OAK DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-4076
Mailing Address - Country:US
Mailing Address - Phone:678-838-8195
Mailing Address - Fax:678-838-8196
Practice Address - Street 1:5497 TWIN OAK DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-4076
Practice Address - Country:US
Practice Address - Phone:678-838-8195
Practice Address - Fax:678-838-8196
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist