Provider Demographics
NPI:1851635494
Name:LEE, SOYUN CHRISTINE (MED, MA, LMHC)
Entity type:Individual
Prefix:
First Name:SOYUN
Middle Name:CHRISTINE
Last Name:LEE
Suffix:
Gender:F
Credentials:MED, MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CORDWAINER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1671
Mailing Address - Country:US
Mailing Address - Phone:781-878-8340
Mailing Address - Fax:
Practice Address - Street 1:200 CORDWAINER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1671
Practice Address - Country:US
Practice Address - Phone:781-878-8340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health