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General NPI Number Information
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NPI Number | 1306386776
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Entity Type | Organization
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Legal Business Name | DARREN A LANE LLC
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Dates
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Enumeration Date | 03/03/2017
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Last Update Date | 03/03/2017
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Provider Practice Location Address
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Address Line | 2400 BLAISDELL AVE STE 206
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-3331
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Country | US
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Telephone | 612-655-6299
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 BLAISDELL AVE STE 206
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-3331
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Country | US
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Telephone | 612-655-6299
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARREN LANE
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Credential |
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Telephone | 612-655-6299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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