Individual
MS. SAMANTHA GWEN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, LASAC
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 589, FORT DEFIANCE, AZ 86504-0589
(928) 729-8500
(928) 729-8000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
13084
AZ
104100000X
Social Worker
11643
AZ
1041C0700X
Clinical Social Worker
Primary
16048
AZ
Other
Enumeration date
03/04/2008
Last updated
10/03/2016
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