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Individual

TANYA LATRICE LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSCP, LPC

Contact information

Practice address
8400 W VIRGINIA AVE APT 2044, PHOENIX, AZ 85037-8377
(763) 703-0298
Mailing address
8400 W VIRGINIA AVE APT 2044, PHOENIX, AZ 85037-8377
(763) 703-0298

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
11291
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1255940185
OK
05
1275355950
AZ
05
200927670
OK
05
201160590
OK
Enumeration date
07/27/2020
Last updated
11/04/2024
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