Individual
LAURA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
436 BLUE BAYOU LN, WINTER SPRINGS, FL 32708-7120
(407) 807-2289
Mailing address
436 BLUE BAYOU LN, WINTER SPRINGS, FL 32708-7120
(407) 807-2289
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
FL
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104158100
—
FL
Enumeration date
12/30/2019
Last updated
12/19/2020
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