Individual
MARK RICHARD LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMIN LPC
Contact information
Practice address
4201 PATTERSON AVE, RICHMOND, VA 23221
(877) 572-3371
Mailing address
4201 PATTERSON AVE, RICHMOND, VA 23221
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
0701002355
VA
Other
Enumeration date
10/04/2006
Last updated
10/24/2007
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