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NPI Code Detail

MEDICARE: AMBER LANE

MEDICARE: AMBER 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
1101YM0800XMental Health Counselor001680IA

General Provider Information

NPI Number : 1720477003
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER LANE
Provider Business Mailing Address
First Line : 705 ELM ST E
Second Line :
City : ROCKWELL
State : IA
Zip : 50469-1035
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 705 ELM ST E
Second Line :
City : ROCKWELL
State : IA
Zip : 50469-1035
Country : US
Telephone Number : 641-372-0315
Fax Number : 866-610-4384
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2015
Last Update Date : 12/13/2022

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Directions to “ AMBER LANE ” Practice Location

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