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Individual

JACQUELINE LAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
900 SHIP POND RD, PLYMOUTH, MA 02360-1849
(508) 224-8041
Mailing address
31 COPPER LANTERN LN, CARVER, MA 02330-1763
(781) 760-3730

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
03/07/2022
Last updated
03/07/2022
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