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Individual
KRISTINE LANE
Active
Individual
KRISTINE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS CAC III
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0020879
CO
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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