Provider Demographics
NPI:1962063594
Name:LEE, R. ANTHONY (DOCTOR OF MINISTRY)
Entity type:Individual
Prefix:DR
First Name:R. ANTHONY
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DOCTOR OF MINISTRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30008
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20030-0008
Mailing Address - Country:US
Mailing Address - Phone:301-516-2158
Mailing Address - Fax:
Practice Address - Street 1:3901 SUITLAND RD APT 416
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-1916
Practice Address - Country:US
Practice Address - Phone:301-516-2158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician