| NPI | 1316412364 |
|---|---|
| Other Name | LISA LAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171W00000X Contractor | |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2018-10-05 |