Individual
MS. ELIZABETH LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED AND LSW
Contact information
Practice address
521 BEALL AVE, WOOSTER, OH 44691-3589
(330) 262-7836
Mailing address
2078 W SMITHVILLE WESTERN RD, WOOSTER, OH 44691-8500
(330) 262-7836
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
S0800835
OH
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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