Individual
MS. LEAH JOHNSON LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
605 CAPITOL PLACE, COLUMBIA, SC 29205
(803) 926-2607
(803) 799-7652
Mailing address
605 CAPITOL PLACE, COLUMBIA, SC 29205
(803) 926-2607
(803) 799-7652
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
51
SC
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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