Individual
KARI LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3050 N ORMSBY BLVD, CARSON CITY, NV 89703-8378
(765) 430-9455
Mailing address
5974 N US HIGHWAY 421, DELPHI, IN 46923-9236
(765) 430-9455
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11355364-4201
UT
225X00000X
Occupational Therapist
20370
CA
225X00000X
Occupational Therapist
31006926A
IN
225X00000X
Occupational Therapist
413311
OR
225X00000X
Occupational Therapist
OT-2283
NV
225X00000X
Occupational Therapist
OT60979418
WA
Other
Enumeration date
06/04/2019
Last updated
10/04/2019
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