Search › Michigan › 104100000X
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 HealthInferred 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