Provider Demographics
NPI:1184954000
Name:DENBRABER-LAKE, AMANDA MARIE (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:MARIE
Last Name:DENBRABER-LAKE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 794
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48805-0794
Mailing Address - Country:US
Mailing Address - Phone:517-282-7779
Mailing Address - Fax:517-394-3604
Practice Address - Street 1:124 E WASHINGTON ST STE C
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-8826
Practice Address - Country:US
Practice Address - Phone:517-282-7779
Practice Address - Fax:517-394-3604
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2025-03-31
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist