Individual
AMANDA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4000 28TH AVE S, MOORHEAD, MN 56560-7926
(701) 417-6999
Mailing address
302 SOUTH ST APT 101, MORRIS, MN 56267-1558
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
541
ND
103T00000X
Psychologist
Primary
LP5983
MN
Other
Enumeration date
02/21/2016
Last updated
04/21/2026
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