Organization
CANDACE LAKE MS LMHC PA
Active
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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