Most Relevant Information
Provider Data
| NPI Number: | 1003230657 |
| Provider Name: | SUSAN LEE |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | SW2323 |
Most Important Dates
| Enumeration Date: | 02/18/2014 |
| Last Updated: | 06/16/2015 |
Provider Practice Location
12086 FT.CAROLINE RD SUITE 401
JACKSONVILLE
FL
322251536
Practice Location Phone/Fax
| Phone: | 9045651271 |
| Fax: | 9046457325 |
Provider Mailing Location
12086 FORT CAROLINE RD
JACKSONVILLE
FL
322252687
Provider Mailing Phone/Fax
| Phone: | 9045651271 |
| Fax: | 9046457325 |