Individual
DR. GREGORY P. LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
222 W THOMAS RD STE 315, PHOENIX, AZ 85013
(602) 406-3671
Mailing address
240 W THOMAS RD # 301, PHOENIX, AZ 85013-4407
(602) 406-3671
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
001130
GA
103G00000X
Clinical Neuropsychologist
Primary
4848
AZ
103TC0700X
Clinical Psychologist
1130
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000338434A
—
GA
01
—
PS0182
SC MEDICAID
SC
Enumeration date
08/30/2006
Last updated
10/05/2020
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