Most Relevant Information
Provider Data
| NPI Number: | 1003694506 |
| Provider Name: | CASSIDY LEE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/18/2023 |
| Last Updated: | 09/18/2023 |
Provider Practice Location
1011 MEADOWLANDS DR STE 1&2
WHITE BEAR LAKE
MN
551272339
Practice Location Phone/Fax
| Phone: | 6124450302 |
| Fax: |
Provider Mailing Location
1011 MEADOWLANDS DR STE 1&2
WHITE BEAR LAKE
MN
551272339
Provider Mailing Phone/Fax
| Phone: | 6124450302 |
| Fax: |