Individual
KAITLYN TAYLOR LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1200 MARQUETTE AVE, MINNEAPOLIS, MN 55403-2419
(612) 503-1954
Mailing address
1200 MARQUETTE AVE, MINNEAPOLIS, MN 55403-2419
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MN
101YP2500X
Professional Counselor
—
MN
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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