Individual
TAWANNA CH'CON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST, SUITE 200, FOREST HILLS, NY 11375-1022
(718) 762-7633
(718) 886-8694
Mailing address
9204 93RD AVE, WOODHAVEN, NY 11421-3009
(917) 687-6170
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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