Individual
MRS. PAMELA LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1360 GRAY FOX DR, NORTH CANTON, OH 44720-1014
(330) 283-0928
Mailing address
1360 GRAY FOX DR, NORTH CANTON, OH 44720-1014
(330) 283-0928
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
11/18/2010
Last updated
08/26/2019
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