Individual
DONIELLE LAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15536 N 159TH LN, SURPRISE, AZ 85374-7829
(623) 398-8443
Mailing address
15508 W BELL RD STE 101-464, SURPRISE, AZ 85374-2432
(480) 622-3175
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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