Idasha Lee

NPI #1346819521 in Pooler, Georgia

Provider Information

NPI Number: 1346819521
Entity Type: Individual
Name: Idasha Lee
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jun 22, 2021
Last Updated: Jun 22, 2021

Practice Location

Address: 105 GRAND CENTRAL BLVD
City: Pooler
State: Georgia
ZIP Code: 31322-4148
Phone: (912) 244-3305

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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