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NPI Code Detail

MEDICARE: CANDICE LANE

MEDICARE: CANDICE LANE
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1598624637
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE LANE
Provider Business Mailing Address
First Line : 10015 OLD COLUMBIA RD STE B215
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-1865
Country : US
Telephone Number : 443-212-8157
Fax Number :
Provider Business Practice Location Address
First Line : 10015 OLD COLUMBIA RD STE B215
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-1865
Country : US
Telephone Number : 443-212-8157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2026
Last Update Date : 01/19/2026

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Directions to “ CANDICE LANE ” Practice Location

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