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Mary Catherine Lee

Student in an Organized Health Care Education/Training Program in Hattiesburg, MS. Individual provider (NPI-1).

NPI number1053901736
StatusActive
Last updated in NPPESJan 26, 2021

Details

NPI
1053901736
Entity type
Individual (NPI-1)
Name
Mary Catherine Lee
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 26, 2021
Certification date
Sep 26, 2020
Last updated
Jan 26, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

118 College Dr
Hattiesburg, MS 39406-0002

Phone 601-266-6508

Mailing address

126 Lake Village Dr
Madison, MS 39110-6520

Phone 601-953-7735

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