Individual
MRS. PATRICIA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 ANTLER DR, TROY, IL 62294-2479
(618) 531-9574
Mailing address
1204 ANTLER DR, TROY, IL 62294-2479
(618) 531-9574
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/28/2012
Last updated
04/04/2012
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