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General NPI Number Information
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NPI Number | 1609968296
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Entity Type | Individual
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Provider Name | DIANE SUE MCLANE LPC
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2250 N CRAYCROFT RD SUITE 250
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City | TUCSON
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State | AZ
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Zip | 85712-2802
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Country | US
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Telephone | 520-546-4459
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Fax | 520-546-4494
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Provider Business Mailing Address
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Address Line | 2250 N CRAYCROFT RD SUITE 250
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City | TUCSON
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State | AZ
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Zip | 85712-2802
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Country | US
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Telephone | 520-546-4459
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Fax | 520-546-4494
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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 | LPC-1238
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License Number State | AZ
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Legacy Identifiers
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Identifier #1
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Identifier Code | 713562
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Identifier Type | OTHER
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Identifier State | AS
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Identifier Issuer | AHCCCS
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 713562
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Identifier Type | OTHER
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Identifier State | AS
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Identifier Issuer | AHCCCS
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