Individual
BAO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3518 MEMORIAL DR, BLDG 4, MADISON, WI 53704-1574
(608) 280-4760
Mailing address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
(608) 280-2636
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3125-226
WI
Other
Enumeration date
07/13/2016
Last updated
08/31/2016
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