Beverly Lake
NPI #1790099117 in Tucumcari, New Mexico
Provider Information
- NPI Number
- 1790099117
- Entity Type
- Individual
- Name
- Beverly Lake
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor
- Enumeration Date
- Jul 27, 2010
- Last Updated
- Jul 27, 2010
Practice Location
- Address
- 1110 E HIGH ST
- City
- Tucumcari
- State
- New Mexico
- ZIP Code
- 88401-2510
- Phone
- (575) 461-4411
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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