Individual
MS. ALLYSON LYNN LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COUNSELOR
Contact information
Practice address
37 CASTANO, RANCHO SANTA MARGARITA, CA 92688-1663
(949) 444-1515
Mailing address
37 CASTANO, RANCHO SANTA MARGARITA, CA 92688-1663
(949) 444-1515
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
081697
CA
Other
Enumeration date
07/13/2011
Last updated
07/13/2011
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