Individual
DR. KAREN D LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1 WINDSOR CV, SUITE 108, COLUMBIA, SC 29223-1833
(803) 699-8887
(803) 699-8824
Mailing address
1012 BALLENTINE RD, BLYTHEWOOD, SC 29016-8346
(803) 699-8887
(803) 699-8824
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
000690
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0264
—
SC
Enumeration date
03/09/2006
Last updated
08/08/2007
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