Individual
DR. RENEE ANNE LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3003 DUNES WEST BLVD STE 3, MOUNT PLEASANT, SC 29466-8001
(843) 352-4060
Mailing address
2655 PARK WEST BLVD, MOUNT PLEASANT, SC 29466-7246
(315) 521-3166
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4708
SC
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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