Individual
TYLAN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
860 EAST RIVER PLACE SUITE 100, JACKSON, MS 39202
(769) 251-5550
Mailing address
2525 YOUREE DR SUITE 110, SHREVEPORT, LA 71104
(318) 742-3408
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/06/2017
Last updated
06/06/2017
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