Michael Lake's National Provider Identifier (NPI) Details
Michael Lake, LMHC
NPI: 1265596035
Enumeration Date: 2006-12-19
Last updated: 2018-09-25
Sole Proprietor: YES
Status: active
Postal Address: 4450 EAU GALLIE BLVD, SUITE 200, MELBOURNE, FL
Phone: 321-726-2860
Primary Practice Address: 400 EAST SHERIDAN RD, MELBOURNE, FL
Practice's phone: 321-722-5200