Kennady Lake, AAC, CPC

NPI #1619747649 in Longview, Washington

Provider Information

NPI Number: 1619747649
Entity Type: Individual
Name: Kennady Lake, AAC, CPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Credential: AAC, CPC
Enumeration Date: Jan 2, 2024
Last Updated: Jan 2, 2024

Practice Location

Address: 1400 COMMERCE AVE
City: Longview
State: Washington
ZIP Code: 98632-3756
Phone: (360) 998-2047

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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