SearchMichigan104100000X

Bradley Lake, LMSW

NPI 1083261705 · on the registry since 2019

Practice

Address
2925 Russell St
Detroit, MI 48207
Phone
(313) 396-5300
Fax
(313) 396-5353
Organisation at this address
Team Wellness Center
Team Wellness Center
Team Wellness Center
Dundee Family Pharmacy Llc
Saturn Science Integrated Health
Inferred from a shared address, not stated in the registry.
Clinicians at this address
283

Registry record

Primary taxonomy
104100000X
104100000X
Also registered as
1041C0700X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-07-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan