Provider Demographics
NPI:1699097212
Name:LEE, ESTHER (MA, SLP-CCC)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MA, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11105 KNOTT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5137
Mailing Address - Country:US
Mailing Address - Phone:714-893-7399
Mailing Address - Fax:714-893-7389
Practice Address - Street 1:11105 KNOTT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5137
Practice Address - Country:US
Practice Address - Phone:714-893-7399
Practice Address - Fax:714-893-7389
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 16645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist