Individual
STEPHANIE LASANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2711 COLONIAL DR, COLUMBIA, SC 29203-6818
(803) 726-9300
Mailing address
2711 COLONIAL DR, COLUMBIA, SC 29203-6818
(803) 878-1076
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57-0510076
—
SC
Enumeration date
10/25/2022
Last updated
10/25/2022
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