JASON BENNETT LAKE

RALEIGH, NC
NPI1922304948
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NC  C006990)
Enumeration Date2011-02-09
Last Update Date2014-02-17
Business Address
-- JASON BENNETT LAKE LCSW
1100 LOGGER CT G-103
RALEIGH, NC 27609-8525
Phone number: 919-538-5511
Mailing Address
-- JASON BENNETT LAKE LCSW
1100 LOGGER CT STE G103
RALEIGH, NC 27609-8512
Phone number: 919-538-5511
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