EDWARD LAKE

BALLSTON SPA, NY
NPI1427319409
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TS0200X Psychologist School
Enumeration Date2012-06-06
Last Update Date2012-06-06
Business Address
EDWARD LAKE NCSP
39 LEWIS ST
BALLSTON SPA, NY 12020-1925
Phone number: 518-885-9863
Mailing Address
EDWARD LAKE NCSP
39 LEWIS ST
BALLSTON SPA, NY 12020-1925
Phone number: 518-885-9863
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