Individual
SYLVIA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD,
Contact information
Practice address
810 N WALL ST, CARBONDALE, IL 62901-1735
(773) 551-7536
Mailing address
810 N WALL ST, CARBONDALE, IL 62901-1735
(773) 551-7536
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.007520
IL
Other
Enumeration date
10/02/2006
Last updated
03/16/2022
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