Organization
THEODORE W. LANE PHD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE W LANE PH.D. (SOLE MEMBER)
(910) 692-9100
Entity
Organization
Contact information
Practice address
185 E NEW HAMPSHIRE AVE, SOUTHERN PINES, NC 28387-5529
(910) 692-9100
(910) 692-9109
Mailing address
185 E NEW HAMPSHIRE AVE, SOUTHERN PINES, NC 28387-5529
(910) 692-9100
(910) 692-9109
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1264
NC
Other
Enumeration date
04/06/2016
Last updated
04/06/2016
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