Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC009496 | GA |
NPI | 1003223074 |
---|---|
Provider Name | Lashonda Lane |
First Address | Atlanta, GA 30336-2659 |
Second Address | Atlanta, GA 30336-2659 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2014 |
Last Update Date | 24/08/2020 |