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Individual

EMILY S LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3001 MONTVALE DR STE F, SPRINGFIELD, IL 62704-5361
(217) 836-6101
Mailing address
1605 S DOUGLAS AVE, SPRINGFIELD, IL 62704-3517
(217) 836-6101

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-014465
IL

Other

Enumeration date
08/15/2012
Last updated
08/06/2023
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