Healthcare Provider Details

I. General information

NPI: 1407191505
Provider Name (Legal Business Name): HANNAH CHRISTINE LANE AA HUMAN SERVICES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2012
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2172 S TRENTON WAY APT 1-303 1-303
DENVER CO
80231-5381
US

IV. Provider business mailing address

2172 S TRENTON WAY APT 1-303 1-303
DENVER CO
80231-5381
US

V. Phone/Fax

Practice location:
  • Phone: 502-526-7702
  • Fax:
Mailing address:
  • Phone: 303-802-7770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: