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Individual

STACEY MARIE LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2622 PIONEER AVE, CHEYENNE, WY 82001-3024
(307) 287-7685
(307) 248-5600
Mailing address
2622 PIONEER AVE, CHEYENNE, WY 82001-3024
(307) 287-7685
(307) 248-5600

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
932
WY

Other

Enumeration date
02/21/2013
Last updated
07/27/2022
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