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1982879490
DERRICK CHRISTOPHER LAKE
DECATUR, GA
NPI
1982879490
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: GA csw1003152)
Enumeration Date
2008-04-25
Last Update Date
2018-03-17
Business Address
DERRICK CHRISTOPHER LAKE LCSW
4229 SNAPFINGER WOODS DR
DECATUR, GA 30035-3440
Phone number: 404-286-9252
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Mailing Address
DERRICK CHRISTOPHER LAKE LCSW
4229 SNAPFINGER WOODS DR
DECATUR, GA 30035-3440
Phone number: 404-286-9252
Copy
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