Alyssa Amber Lake
NPI #1124504089 in Vallejo, California
Provider Information
- NPI Number
- 1124504089
- Entity Type
- Individual
- Name
- Alyssa Amber Lake
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Jul 13, 2018
- Last Updated
- Jul 13, 2018
Practice Location
- Address
- 150 GLEN COVE MARINA RD E
- City
- Vallejo
- State
- California
- ZIP Code
- 94591-7292
- Phone
- (707) 553-1784
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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