Provider Demographics
NPI:1164248068
Name:LEE, CIARA H (CPM)
Entity type:Individual
Prefix:MRS
First Name:CIARA
Middle Name:H
Last Name:LEE
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 TRAVIS DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:OH
Mailing Address - Zip Code:45431-2373
Mailing Address - Country:US
Mailing Address - Phone:937-681-5796
Mailing Address - Fax:
Practice Address - Street 1:215 TRAVIS DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:OH
Practice Address - Zip Code:45431-2373
Practice Address - Country:US
Practice Address - Phone:937-681-5796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife