Individual
ELIZABETH LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 FRONTAGE RD STE B, O FALLON, IL 62269-2093
(480) 242-6494
Mailing address
1115 FRONTAGE RD STE B, O FALLON, IL 62269-2093
(480) 242-6494
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178017183
IL
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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