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Donita Michelle Lake
Mental Health Counselor in Mokena, Illinois
NPI 1710695531

Donita Michelle Lake is a Mental Health Counselor based in Bolingbrook, IL and is specialized in Mental Health. Donita Michelle Lake practices in Mokena, IL. The NPI Number for Donita Michelle Lake is 1710695531 and holds a License No. (Illinois).

The current practice location address for Donita Michelle Lake is 11225 Front St, Mokena, IL and can be reached out via phone at 708-537-7332.

Location: 11225 Front St, Mokena, IL, 60490-6571
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710695531
Provider Name
Donita Michelle Lake
Credential
Provider Entity Type
Individual
Gender
Female
Address
11225 Front St, Mokena, IL, 60490-6571
Phone Number
708-537-7332
Fax Number
Provider Enumeration Date
11/10/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
11225 Front St
City
Mokena
State
Illinois
Zip
60448-1303
Phone Number
708-537-7332
Fax Number
person
Provider Business Mailing Address Details
Address
11225 Front St
City
Mokena
State
Illinois
Zip
60448-1303
Phone Number
708-537-7332
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
(Illinois)
Definition
Definition to come...
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