Provider Demographics
NPI:1760205512
Name:LEE, JULIA GRACE
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:GRACE
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 FAWN LN
Mailing Address - Street 2:
Mailing Address - City:OWINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20736-3512
Mailing Address - Country:US
Mailing Address - Phone:443-684-6336
Mailing Address - Fax:
Practice Address - Street 1:1125 FAWN LN
Practice Address - Street 2:
Practice Address - City:OWINGS
Practice Address - State:MD
Practice Address - Zip Code:20736-3512
Practice Address - Country:US
Practice Address - Phone:443-684-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool