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NPI Code Detail

MEDICARE: MRS. BRITTANY GAIL LANE LAC

MEDICARE: MRS. BRITTANY GAIL LANE LAC
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
1101Y00000XCounselorA1302020AR

General Provider Information

NPI Number : 1598103376
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRITTANY GAIL LANE LAC
Provider Business Mailing Address
First Line : 10800 FINANCIAL CENTRE PKWY STE 290
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-3581
Country : US
Telephone Number : 501-781-2230
Fax Number :
Provider Business Practice Location Address
First Line : 10800 FINANCIAL CENTRE PKWY STE 290
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-3581
Country : US
Telephone Number : 501-781-2230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2013
Last Update Date : 06/13/2013

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Directions to “ MRS. BRITTANY GAIL LANE LAC” Practice Location

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