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Individual

IVY LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
7001 JOHNNYCAKE RD STE 101, WINDSOR MILL, MD 21244-2419
(443) 522-0064
Mailing address
7001 JOHNNYCAKE RD STE 101, WINDSOR MILL, MD 21244-2419
(443) 522-0064

Taxonomy

Speciality
Code
Description
License number
State
163WM1400X
Nurse Massage Therapist (NMT)
Primary
R169873
MD

Other

Enumeration date
06/22/2023
Last updated
06/30/2023
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