| NPI | 1609287028 |
|---|---|
| Former Legal Business Name | FANIA LEE PSYD HSPP |
| Entity Type | Organization |
| Authorized Contact | FANIA LEE Licensed Clinical Psychologist 812-455-6597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |