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1962991588
JALISSA LAKE
TAMPA, FL
NPI
1962991588
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-05-09
Last Update Date
2022-10-23
Business Address
JALISSA LAKE
4940 NORTHDALE BLVD
TAMPA, FL 33624-1075
Phone number: 813-485-8444
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Mailing Address
JALISSA LAKE
7108 SOUTH KANNER HWY,
STUART, FL 34997-7462
Phone number: 866-610-0580
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