Individual
MS. KATRINA SHIVAUN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3101 FAYETTEVILLE RD, SUITE E, LUMBERTON, NC 28358-2775
(910) 737-6300
(910) 737-6333
Mailing address
209 RENTON CT, FAYETTEVILLE, NC 28311-3414
(910) 737-6300
(910) 737-6333
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
NC-5040
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7411871
—
NC
01
—
NC-5040
NC STATE LICENSE ID#
NC
Enumeration date
12/21/2006
Last updated
04/29/2009
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