IndividualActive
Amanda Lake
NPI 1992998900 · Marriage & Family Therapist · Janesville, WI
Provider details
- NPI number
- 1992998900
- Entity type
- Individual
- Primary specialty
- Marriage & Family TherapistBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 10097 (IA)
Practice location
113 S Franklin St
Janesville, WI 53548-3812
Phone: (608) 743-2417
Fax: (608) 743-2406
Mailing address
113 S Franklin St
Janesville, WI 53548-3812
Registry dates
- Enumerated
- 2007-08-22
- Last updated
- 2014-12-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.