Individual
STEPHANIE A LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 SEAPORT LN UNIT 1331, MT PLEASANT, SC 29464-2731
(828) 776-0314
Mailing address
300 SEAPORT LN UNIT 1331, MT PLEASANT, SC 29464-2731
(828) 776-0314
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5264
SC
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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