Individual
MRS. ELIZABETH LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 CHIEF EDDIE HOFFMAN, BETHEL, AK 99559
(907) 543-6300
(907) 543-6366
Mailing address
PO BOX 528, BETHEL, AK 99559-0528
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM1421
—
AK
Enumeration date
04/23/2007
Last updated
12/06/2012
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