Individual
SU JIN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
298 CLEAR SKY CT STE G, CLARKSVILLE, TN 37043-5685
(931) 542-2739
Mailing address
550 NEW SOUTH DR APT 1207, CLARKSVILLE, TN 37043-8429
(813) 435-8328
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1229
ND
235Z00000X
Speech-Language Pathologist
17738
CA
235Z00000X
Speech-Language Pathologist
4230
KY
235Z00000X
Speech-Language Pathologist
Primary
4980
TN
235Z00000X
Speech-Language Pathologist
8971
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201086967
USCIS NUMBER
—
Enumeration date
06/17/2013
Last updated
03/06/2025
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