Individual
JENNIFER MARIE LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LMFT
Contact information
Practice address
2233 N. HAMLINE AVE., SUITE 411, ROSEVILLE, MN 55113
(612) 799-8258
(651) 330-8718
Mailing address
8119 50TH AVE. N., NEW HOPE, MN 55428
(612) 799-8258
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2425
MN
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
12/06/2010
Last updated
10/22/2015
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