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Individual

COURTNEY L LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
300 N MICHIGAN ST, SUITE 420, SOUTH BEND, IN 46601-1295
(574) 291-9300
(574) 291-9301
Mailing address
57757 PEAR RD., SOUTH BEND, IN 46619
(574) 876-8697

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
03/06/2007
Last updated
05/04/2012
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