Healthcare Provider Details

I. General information

NPI: 1639686280
Provider Name (Legal Business Name): BRITTANY LEE LANCE LPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 HENDERSONVILLE RD
FLETCHER NC
28732-6606
US

IV. Provider business mailing address

5010 HENDERSONVILLE RD
FLETCHER NC
28732-6606
US

V. Phone/Fax

Practice location:
  • Phone: 828-884-2475
  • Fax:
Mailing address:
  • Phone: 828-884-2475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5268
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: