Individual
JACKIE M LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AADP
Contact information
Practice address
50 W 75TH ST, SUITE 3B, NEW YORK, NY 10023-2024
(917) 202-2647
Mailing address
50 W 75TH ST, SUITE 3B, NEW YORK, NY 10023-2024
(917) 202-2647
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
02/29/2012
Last updated
02/29/2012
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