Individual
JIN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3 COLUMBUS CIR STE 1425, NEW YORK, NY 10019-8720
(212) 342-3800
Mailing address
200 W 112TH ST APT 1A, NEW YORK, NY 10026-3529
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
025423
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285628552
AGENCY
—
Enumeration date
05/26/2017
Last updated
09/29/2023
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