Individual
MRS. ELISA PETRA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3957 SALT CREEK WAY, ONTARIO, CA 91761-0211
(951) 358-6858
Mailing address
3957 SALT CREEK WAY, ONTARIO, CA 91761-0211
(951) 358-6858
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22130
CA
Other
Enumeration date
09/26/2007
Last updated
09/26/2007
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