Provider Demographics
NPI:1124832407
Name:LEE, DONNA B
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:B
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2559 MEDICAL DR STE B
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-8704
Mailing Address - Country:US
Mailing Address - Phone:575-446-5085
Mailing Address - Fax:844-203-5924
Practice Address - Street 1:2559 MEDICAL DR STE B
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-8704
Practice Address - Country:US
Practice Address - Phone:575-446-5085
Practice Address - Fax:844-203-5924
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach