Individual
JENNA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9719 NORTHEAST PKWY, MATTHEWS, NC 28105-9712
(704) 443-8148
Mailing address
13209 INDIAN HILLS LN, CHARLOTTE, NC 28278-7140
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A17813
NC
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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