Organization
CANDACE LAKE MS LMHC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CANDACE RENEE LAKE MS (OWNER)
(561) 271-0681
Entity
Organization
Contact information
Practice address
1650 NE 26TH ST STE 201, WILTON MANORS, FL 33305-1431
(561) 271-0681
Mailing address
2883 NE 15TH ST, POMPANO BEACH, FL 33062-3611
(561) 271-0681
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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