SAMANTHA RAE LAKE

BRAINERD, MN
NPI1740852284
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
Additional Taxonomies104100000X Social Worker
(Licence: MN  26980)
Enumeration Date2021-07-14
Last Update Date2024-08-21
Business Address
SAMANTHA RAE LAKE LICSW
823 MAPLE ST
BRAINERD, MN 56401-3770
Phone number: 218-454-3826
Mailing Address
SAMANTHA RAE LAKE LICSW
823 MAPLE ST
BRAINERD, MN 56401-3770
Phone number: