Provider Demographics
NPI:1154123693
Name:LEE, ERICA DELORES
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:DELORES
Last Name:LEE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 GABLE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3667
Mailing Address - Country:US
Mailing Address - Phone:216-903-4193
Mailing Address - Fax:
Practice Address - Street 1:1367 GABLE LN
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3667
Practice Address - Country:US
Practice Address - Phone:216-903-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant