Lee Tyson Wade, LPC

NPI #1174887483 in Valdosta, Georgia

Provider Information

NPI Number: 1174887483
Entity Type: Individual
Name: Lee Tyson Wade, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Credential: LPC
Enumeration Date: Jul 2, 2012
Last Updated: Jul 2, 2012

Practice Location

Address: 1205 BAYTREE ROAD
Address 2: #8
City: Valdosta
State: Georgia
ZIP Code: 31602
Phone: (229) 244-5533

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary
Counselor - Professional — Professional	101YP2500X

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