Provider Demographics
NPI:1366233389
Name:LEE, TONYA DENISE
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:DENISE
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 1:4773 PRICE ST
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-1951
Mailing Address - Country:US
Mailing Address - Phone:719-964-1281
Mailing Address - Fax:
Practice Address - Street 1:4773 PRICE ST
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-1951
Practice Address - Country:US
Practice Address - Phone:719-964-1281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist