Individual
JESSICA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 MENAUL BLVD NW STE A-216, ALBUQUERQUE, NM 87107-1322
(505) 633-7170
Mailing address
300 MENAUL BLVD NW STE A-216, ALBUQUERQUE, NM 87107-1322
(505) 633-7170
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/19/2016
Last updated
05/05/2023
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