Individual
GRACE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22-08 ROUTE 208, FAIR LAWN, NJ 07410-2609
(201) 956-6363
Mailing address
1071 WASHINGTON AVE N, OLD TAPPAN, NJ 07675-7037
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P116363
NY
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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