Individual
KATIE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
176 HARTS FORD WAY, BROWNSBURG, IN 46112-8133
(317) 294-3361
Mailing address
176 HARTS FORD WAY, BROWNSBURG, IN 46112-8133
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
976
HI
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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