Blue Lake Services PC

NPI #1104272269 in Lakewood, New Jersey

Provider Information

NPI Number
1104272269
Entity Type
Organization
Organization Name
Blue Lake Services PC
Primary Specialty
Social Worker - Clinical
Enumeration Date
May 9, 2016
Last Updated
May 9, 2016

Practice Location

Address
1858 ATTAYA RD
ZIP Code
08701-2901
Phone
(718) 534-0689

Authorized Official

Name
MEYER SEEVE
Title
OWNER
Phone
(718) 534-0689

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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