Individual
ANNE LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9818 E NAVARRO AVE, MESA, AZ 85209-2518
(480) 808-0665
Mailing address
9221 E BASELINE RD, STE 109 #193, MESA, AZ 85209
(480) 808-0665
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP6281
AZ
Other
Enumeration date
09/22/2009
Last updated
02/16/2023
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