Individual
JASON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30800 CHAGRIN BLVD, PEPPER PIKE, OH 44124-5925
(216) 591-0324
Mailing address
8445 MUNSON RD, MENTOR, OH 44060-2410
(440) 255-1700
(440) 205-2417
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2864093
—
OH
Enumeration date
03/27/2023
Last updated
10/02/2023
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