Individual
BRENDA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
US HWY 160 S MP 394.3, KAYENTA, AZ 86033-0368
(928) 697-4000
(928) 697-4152
Mailing address
PO BOX 368, KAYENTA, AZ 86033-0368
(928) 697-4000
(928) 697-4145
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
M-06289
NM
104100000X
Social Worker
Primary
M-06289
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80525857
—
NM
Enumeration date
05/04/2007
Last updated
06/20/2019
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