Individual
CORY ANDREW LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-SLP
Contact information
Practice address
11455 PRINCE GEORGE DR, DISPUTANTA, VA 23842-6032
(111) 070-7084
Mailing address
2512 MISTWOOD FOREST DR, CHESTER, VA 23831-7029
(540) 266-0453
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010539
VA
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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