Provider Demographics
NPI:1285403048
Name:LEE, DANIELLE YVONNE (MBA, RD, LD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:YVONNE
Last Name:LEE
Suffix:
Gender:F
Credentials:MBA, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MCCLENNAN BANKS DR RM 7019
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1164
Mailing Address - Country:US
Mailing Address - Phone:843-876-9456
Mailing Address - Fax:
Practice Address - Street 1:10 MCCLENNAN BANKS DR RM 7019
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1164
Practice Address - Country:US
Practice Address - Phone:843-876-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2584133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered