Individual
AMY MARIE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-A
Contact information
Practice address
4200 NE SUWANNEE DR, LEES SUMMIT, MO 64064-1381
(816) 686-7708
Mailing address
4200 NE SUWANNEE DR, LEES SUMMIT, MO 64064-1381
(816) 686-7708
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2002028924
MO
231H00000X
Audiologist
2003
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100449020A
—
KS
05
—
336016308
—
MO
Enumeration date
05/10/2006
Last updated
03/31/2010
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