Individual
ANGELIQUE MONICA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
2708 WESTMOOR CT SW, OLYMPIA, WA 98502-5754
(360) 943-8810
Mailing address
1913 BISHOP RD, CHEHALIS, WA 98532-8746
(360) 431-1552
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61655108
WA
Other
Enumeration date
04/07/2025
Last updated
05/05/2025
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