Individual
MRS. CRISTAL LYNN LAKE-SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LPC, M.ED.
Contact information
Practice address
4906 MILLRIDGE PKWY E, MIDLOTHIAN, VA 23112-4828
(804) 399-0676
(804) 744-5202
Mailing address
14308 LONG HILL RD, MIDLOTHIAN, VA 23112-4302
(804) 399-0676
(804) 744-5202
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004299
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992959928
—
VA
Enumeration date
02/17/2009
Last updated
02/19/2010
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