Individual
MS. JACQUELINE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8500 WASHINGTON ST NE STE A1, ALBUQUERQUE, NM 87113-1861
(505) 828-3837
Mailing address
8500 WASHINGTON ST NE STE A1, ALBUQUERQUE, NM 87113-1861
(505) 828-3837
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-16-23678
NM
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/03/2015
Last updated
09/30/2016
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