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Individual
TAMERA NICOLE LAKE
Active
Individual
TAMERA NICOLE LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S.2411297
SOCIAL WORK
OH
Enumeration date
11/21/2023
Last updated
09/12/2024
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