Individual
NATALIE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1276 FULTON AVE, BRONX, NY 10456-3402
(718) 901-8747
Mailing address
1276 FULTON AVE, BRONX, NY 10456-3402
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11930
NY
Other
Enumeration date
02/03/2009
Last updated
02/03/2009
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