Provider Demographics
NPI:1285813253
Name:DERBYSHIRE, LEE W (MFT)
Entity type:Individual
Prefix:MS
First Name:LEE
Middle Name:W
Last Name:DERBYSHIRE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512
Mailing Address - Country:US
Mailing Address - Phone:775-328-3775
Mailing Address - Fax:775-328-6193
Practice Address - Street 1:1155 E 9TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512
Practice Address - Country:US
Practice Address - Phone:775-328-3775
Practice Address - Fax:775-328-6193
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2016-11-21
Deactivation Date:2016-10-11
Deactivation Code:
Reactivation Date:2016-11-21
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist