Mary T Lake, SLP
NPI #1821203100 in Oak Forest, Illinois
Provider Information
- NPI Number
- 1821203100
- Entity Type
- Individual
- Name
- Mary T Lake, SLP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Speech-Language Pathologist
- Credential
- SLP
- Enumeration Date
- May 11, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 15700 TERRACE DR # P102
- City
- Oak Forest
- State
- Illinois
- ZIP Code
- 60452-2959
- Phone
- (708) 717-4924
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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