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General NPI Number Information
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NPI Number | 1093024655
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Entity Type | Individual
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Provider Name | LANE KATHERINE DAVID L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 09/30/2010
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 600 JEFFERSON ST SUITE 903
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City | LAFAYETTE
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State | LA
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Zip | 70501-6942
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Country | US
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Telephone | 337-412-5102
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Fax |
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Provider Business Mailing Address
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Address Line | 102 REBECCA DR
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City | LAFAYETTE
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State | LA
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Zip | 70508-5966
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Country | US
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Telephone | 337-781-6459
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4192
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License Number State | LA
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