Individual
SUSAN MARIE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26177 W GRASS LAKE RD, ANTIOCH, IL 60002-9613
(847) 395-1550
Mailing address
213 CANNON RD, VOLO, IL 60073-8180
(847) 207-1006
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
42989
IL
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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