Provider Demographics
NPI:1912616715
Name:LEE, VALERIE SUE
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:SUE
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 W MARY LYNN DR
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-6250
Mailing Address - Country:US
Mailing Address - Phone:918-955-0806
Mailing Address - Fax:
Practice Address - Street 1:718 W MARY LYNN DR
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-6250
Practice Address - Country:US
Practice Address - Phone:918-955-0806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist