Individual
MARGARET LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-6043
(314) 454-4801
Mailing address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-5687
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
2001026115
MO
Other
Enumeration date
07/18/2006
Last updated
11/09/2016
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