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DR. ILENE LEE PH.D.
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1629663489
Individual Registrant:DR. ILENE LEE PH.D.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
2915 FOREST AVE BERKELY, CA 94705 US
Tel: 415-724-8060 Fax: --
Tel: 415-724-8060 Fax: --
Contact information for business:
1442 A WALNUT ST. STE 289 BERKELY, CA 94709 US
Tel: 510-684-7025 Fax: --
Tel: 510-684-7025 Fax: --
Registration Information:
NPI: 1629663489
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
