Individual
LORRI K LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPCI
Contact information
Practice address
177 PRICE AVE, SALT LAKE CITY, UT 84115-4345
(801) 269-7564
Mailing address
177 PRICE AVE, SALT LAKE CITY, UT 84115-4345
(801) 269-7564
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5090670-6009
UT
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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