Individual
MS. AMANDA MARIE LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
124 E WASHINGTON ST STE C, DEWITT, MI 48820-8826
(517) 282-7779
(517) 394-3604
Mailing address
PO BOX 794, OKEMOS, MI 48805-0794
(517) 282-7779
(517) 394-3604
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
12/29/2009
Last updated
07/10/2025
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