Individual
KALI LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
904 E MARTIN LUTHER KING DR, CENTRALIA, IL 62801-3058
(618) 533-1391
(618) 533-0012
Mailing address
904 E MARTIN LUTHER KING DR, CENTRALIA, IL 62801-3058
(618) 533-1391
(618) 533-0012
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/01/2026
Last updated
05/01/2026
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