Provider Demographics
NPI:1932257102
Name:LEE, MARY F (MED, LPC, LMFT,)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:F
Last Name:LEE
Suffix:
Gender:F
Credentials:MED, LPC, LMFT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PRESTIGE CIR
Mailing Address - Street 2:SUITE 122
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3432
Mailing Address - Country:US
Mailing Address - Phone:214-509-0500
Mailing Address - Fax:
Practice Address - Street 1:8 PRESTIGE CIR
Practice Address - Street 2:SUITE 122
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3432
Practice Address - Country:US
Practice Address - Phone:214-509-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9471101YP2500X
TX003368106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist