Individual
JISIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
65 N MAPLE AVE STE 202, RIDGEWOOD, NJ 07450-3233
(201) 473-2981
Mailing address
51 WYANDEMERE DR, WOODCLIFF LAKE, NJ 07677-7665
(201) 694-9286
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06995300
NJ
Other
Enumeration date
08/10/2023
Last updated
08/14/2023
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