Provider Demographics
NPI:1679335293
Name:LEE, PAYTON (ME, CCC-SLP)
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:ME, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 PEANUT MILL RD
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:GA
Mailing Address - Zip Code:31824-8643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5547 VETERANS PKWY FL 1
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-4484
Practice Address - Country:US
Practice Address - Phone:803-386-8623
Practice Address - Fax:762-266-1316
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist