Individual
MS. MELVINA SHARON LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMCSW
Contact information
Practice address
1881 SCHIEFFELIN PLACE #4F, BRONX, NY 10466
(718) 708-7911
Mailing address
PO BOX 7083, NEW YORK, NY 10150
(718) 708-7911
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
046956
NY
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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