Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 2414 | NC |
Y | 101YP2500X | Professional Counselor | 9441 | NC |
NPI | 1003199852 |
---|---|
Provider Name | Jonnie Seay Lane |
First Address | Cary, NC 27511-6647 |
Second Address | Cary, NC 27511-6647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2011 |
Last Update Date | 17/03/2018 |