Individual
SHARON ANN LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2509 EIDE ST., ANCHORAGE, AK 99503
(907) 244-8872
(907) 563-3217
Mailing address
8230 KIP CT., ANCHORAGE, AK 99507-3245
(907) 244-8872
(907) 563-3217
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
614
AK
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AK
Enumeration date
01/24/2007
Last updated
05/16/2012
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