Individual
MS. MORIAH R LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
29A EMERSON AVE, GLOUCESTER, MA 01930-2556
(978) 675-9500
Mailing address
29A EMERSON AVE, GLOUCESTER, MA 01930-2556
(978) 675-9500
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
225003
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22503
LICENSED CERTIFIED SOCIAL WORKER
MA
Enumeration date
04/30/2021
Last updated
04/30/2021
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