Individual
LISA LEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2295 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-7801
(843) 766-7103
(843) 763-3834
Mailing address
2295 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-7801
(843) 766-7103
(843) 763-3834
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
4007
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4007
STATE LICENSE
SC
Enumeration date
07/31/2014
Last updated
01/05/2015
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