Individual
DR. TIMOTHY STANLEY LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.DIV. AND D.MIN.
Contact information
Practice address
50 EASTBROOK BND STE B, PEACHTREE CITY, GA 30269-1530
(678) 519-5259
Mailing address
320 SIDNEY LN, FAYETTEVILLE, GA 30215-7646
(770) 371-6821
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
10/17/2020
Last updated
10/17/2020
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