Individual
ASHLEY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2104 GREENBRIAR DR, SOUTHLAKE, TX 76092-8355
(346) 368-4412
Mailing address
2104 GREENBRIAR DR, SOUTHLAKE, TX 76092-8355
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-97937
TX
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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