| NPI | 1629844733 |
|---|---|
| Other Name | SUSAN LAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2025-02-26 |