| Candace Lake Ms Lmhc Pa | |
|
1650 Ne 26th St Ste 201 Wilton Manors FL 33305-1431 | |
| (561) 271-0681 | |
| Not Available |
| Full Name | Candace Lake Ms Lmhc Pa |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1650 Ne 26th St Ste 201, Wilton Manors, Florida |
| Authorized Official Name and Position | Candace Renee Lake (OWNER) |
| Authorized Official Contact | 5612710681 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Candace Lake Ms Lmhc Pa 2883 Ne 15th St Pompano Beach FL 33062-3611 Ph: (561) 271-0681 | Candace Lake Ms Lmhc Pa 1650 Ne 26th St Ste 201 Wilton Manors FL 33305-1431 Ph: (561) 271-0681 |
| NPI Number | 1669094967 |
|---|---|
| Provider Enumeration Date | 05/11/2020 |
| Last Update Date | 05/11/2020 |
| Certification Date | 05/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669094967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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