Individual
JISUN PARK LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, SLP
Contact information
Practice address
2819 RICHMOND DR NE, ALBUQUERQUE, NM 87107-1918
(505) 883-3787
Mailing address
2819 RICHMOND DR NE, ALBUQUERQUE, NM 87107-1918
(505) 883-3787
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF7601
NM
235Z00000X
Speech-Language Pathologist
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Other
Enumeration date
11/05/2021
Last updated
11/05/2021
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