Basic Information
| Provider Information | |||||||||
| NPI: | 1114061439 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 CAREW ST STE 150 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011042391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137486840 | ||||||||
| FaxNumber: | 4137486812 | ||||||||
| Practice Location | |||||||||
| Address1: | 271 CAREW ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011042377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137486840 | ||||||||
| FaxNumber: | 4137486812 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2007 | ||||||||
| LastUpdateDate: | 09/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | WAITING ON | CT | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | 555 | MA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.