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Individual
EVIE LEE
Active
Individual
EVIE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401017881
MI
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401017881
LICENSE NUMBER
MI
Enumeration date
09/27/2017
Last updated
12/23/2019
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