Individual
ANGELA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
901 RIO GRANDE BLVD NW STE G252, ALBUQUERQUE, NM 87104-2050
(505) 585-1570
Mailing address
639 KINLEY AVE NW, ALBUQUERQUE, NM 87102-1282
(505) 948-0763
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-11382
NM
1041S0200X
School Social Worker
M-11382
NM
Other
Enumeration date
10/26/2020
Last updated
10/16/2023
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