Kandi Marie Lake

NPI #1972867067 in Clearfield, Utah

Provider Information

NPI Number: 1972867067
Entity Type: Individual
Name: Kandi Marie Lake
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Jul 3, 2012
Last Updated: Jul 3, 2012

Practice Location

Address: 370 S 500 E
City: Clearfield
State: Utah
ZIP Code: 84015-4057
Phone: (801) 226-7696

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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