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Individual

ELIZABETH NICOLE LAKE

Active
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Individual

ELIZABETH NICOLE LAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, BCBA/LBA

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-63133
CA
103K00000X
Behavior Analyst
1-22-63133
WA
103K00000X
Behavior Analyst
OR
103K00000X
Behavior Analyst
TX

Other

Enumeration date
02/18/2021
Last updated
09/08/2026
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