Individual
CHRISTOPHER NIGEL LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. ED
Contact information
Practice address
9310 QUEENS BLVD APT 4E, REGO PARK, NY 11374-1103
(140) 151-6719
Mailing address
9310 QUEENS BLVD, 4E, REGO PARK, NY 11374-1146
(401) 516-7192
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/02/2014
Last updated
04/03/2020
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