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NPI Code Detail

MEDICARE: DEBORAH LYNN LANE MA LPC

MEDICARE: DEBORAH LYNN LANE MA LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorCC10368AZ

General Provider Information

NPI Number : 1114911724
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH LYNN LANE MA LPC
Provider Business Mailing Address
First Line : 1 W ELLIOT RD
Second Line : SUITE 106
City : TEMPE
State : AZ
Zip : 85284-1310
Country : US
Telephone Number : 480-345-2200
Fax Number : 480-756-2525
Provider Business Practice Location Address
First Line : 1 W ELLIOT RD
Second Line : SUITE 106
City : TEMPE
State : AZ
Zip : 85284-1310
Country : US
Telephone Number : 480-345-2200
Fax Number : 480-756-2525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 11/05/2009

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