Individual
CANDACE RENEE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11120 S CROWN WAY STE 1, WELLINGTON, FL 33414-8718
(561) 790-1191
Mailing address
5347 BUCKHEAD CIR, BOCA RATON, FL 33486-1439
(561) 271-0681
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15452
FL
Other
Enumeration date
01/18/2018
Last updated
01/18/2018
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