Provider Demographics
NPI:1811972524
Name:LEE, JOSEPH YIU CHO (MALP)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:YIU CHO
Last Name:LEE
Suffix:
Gender:M
Credentials:MALP
Other - Prefix:MR
Other - First Name:YIU
Other - Middle Name:CHO
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MALP
Mailing Address - Street 1:5 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2707
Mailing Address - Country:US
Mailing Address - Phone:612-203-1207
Mailing Address - Fax:952-736-2684
Practice Address - Street 1:1885 UNIVERSITY AVE W
Practice Address - Street 2:IRISH PARK PLACE SUITE 25
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3489
Practice Address - Country:US
Practice Address - Phone:612-203-1207
Practice Address - Fax:952-736-2684
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1967103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP27354OtherHEALTH PARTNERS
MN62-22021OtherMEDICA
MN56766LEOtherBLUE CROSS BLUE SHIELD MN
MNA75997205244OtherPREFERREDONE