Individual
LEE ANN DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
104 JORDAN PLAZA BLVD STE 402-403, TYLER, TX 75704-2055
(903) 581-9472
Mailing address
104 JORDAN PLAZA BLVD STE 402-403, TYLER, TX 75704-2055
(903) 581-9472
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8211
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8211
LCDC
TX
Enumeration date
08/11/2016
Last updated
08/11/2016
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