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Individual

CELESTE ILEANA LAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5748 N MESA ST, EL PASO, TX 79912-5427
(915) 224-2443
Mailing address
204 E CLOUD SONG, SANTA TERESA, NM 88008-9419
(915) 549-4405

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
125173
TX

Other

Enumeration date
06/08/2026
Last updated
06/08/2026
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