Individual
ANGELA MICHELLE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
4431 N OLD SCOUT TRL, ENOCH, UT 84721-9729
(435) 865-5600
Mailing address
4431 N OLD SCOUT TRL, ENOCH, UT 84721-9729
(435) 865-5600
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10070021-3502
UT
Other
Enumeration date
01/08/2026
Last updated
01/08/2026
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