Individual
MS. ELAINE IDA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LPC
Contact information
Practice address
S78W18425 LIONS PARK DR APT 1, MUSKEGO, WI 53150-8703
(815) 590-7466
Mailing address
S78W18425 LIONS PARK DR APT 1, MUSKEGO, WI 53150-8703
(815) 590-7466
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
178.005691
IL
103K00000X
Behavior Analyst
Primary
67-140
WI
Other
Enumeration date
05/19/2008
Last updated
08/01/2013
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