Individual
ELLISA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4013 NW EXPRESSWAY STE 105, OKLAHOMA CITY, OK 73116-2618
(405) 378-2727
Mailing address
6700 EAGLES LNDG, OKLAHOMA CITY, OK 73135-1923
(405) 209-7694
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6878
OK
1041C0700X
Clinical Social Worker
Primary
8248
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200817140A
—
OK
Enumeration date
01/17/2019
Last updated
02/27/2023
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