Provider Demographics
NPI:1699464867
Name:LE, MY TEIU
Entity type:Individual
Prefix:
First Name:MY
Middle Name:TEIU
Last Name:LE
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 1:8862 GARDEN GROVE BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1293
Mailing Address - Country:US
Mailing Address - Phone:562-488-7046
Mailing Address - Fax:
Practice Address - Street 1:10021 BROOKSIDE DR
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-1013
Practice Address - Country:US
Practice Address - Phone:714-477-0113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)