Individual
MS. KIMBERLY A LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(705) 653-3880
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(705) 653-3880
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
M7662
MS
104100000X
Social Worker
M7662
MS
1041C0700X
Clinical Social Worker
Primary
2420C
AL
Other
Enumeration date
02/01/2010
Last updated
07/21/2022
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