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Individual
DR. WALTER LEE
Active
Individual
DR. WALTER LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
S25118
TX
103T00000X
Psychologist
S25118
TX
104100000X
Social Worker
S25118
TX
1041C0700X
Clinical Social Worker
Primary
S25118
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01163676
AMERIGROUP
TX
05
—
061168301
—
TX
05
—
061168302
—
TX
Enumeration date
05/07/2007
Last updated
09/16/2009
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