Ricky Lake's National Provider Identifier (NPI) Details
Ricky Lake, LPC
NPI: 1891893699
Enumeration Date: 2006-09-20
Last updated: 2010-11-30
Sole Proprietor: YES
Status: active
Postal Address: 253 OLD PLANK RD, BUTLER, PA
Phone:
Primary Practice Address: 793 OLD ROUTE 119 HWY N, INDIANA, PA
Practice's phone: 724-465-5576