Individual
MRS. KELLY M LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
21910 W 113TH ST N, SEDGWICK, KS 67135-9577
(316) 217-3865
Mailing address
21910 W 113TH ST N, SEDGWICK, KS 67135-9577
(316) 217-3865
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2175
KS
101YP2500X
Professional Counselor
Primary
03759
KS
Other
Enumeration date
05/09/2016
Last updated
07/22/2024
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